67-year-old female presents with chief complaint of shortness of breath, fatigue, weakness, unintentional weight loss, and mild numbness in her feet. She states she feels unsteady when she walks. PMH includes hypothyroidism well controlled on Synthroid 100 mcg/day. No hx of HTN or CHF.

Vital signs: Temp 98.7 F, pulse 118, Respirations 22, BP 108/64, PaO₂ 95% on room air.

Physical exam revealed pale, anxious female appearing older than stated years.

HEENT- pale conjunctiva of eyes and pale palate. Tongue beefy red and slightly swollen with loss of normal rugae. Turbinates pale but no swelling. Thyroid palpable but no nodules felt. No lymph nodes palpated.

Cardiac-regular rate and rhythm with soft II/VI systolic murmur. Respiratory- lungs clear with no adventitious breath sounds. Abdomen-soft, non-tender with positive bowel sounds. Liver edge palpated two finger breadths below right costal margin. Lab data- hgb, hct, reticulocyte count, serum B₁₂ levels low, mean corpuscle volume, plasma iron, and ferritin levels high, folate, TIBC are normal.

Important 2 to 3 pages paper and please include reference page

• Explain the following related to this case study: Anemia and the different kinds of anemia (i.e., micro and macrocytic).
• You do not need to address these other questions
• The factors that affect fertility (STDs).
• Why inflammatory markers rise in STD/PID.
• Why prostatitis and infection happens. Also explain the causes of systemic reaction.
• Why a patient would need a splenectomy after a diagnosis of ITP
• Use this textbook;
  

  McCance, K.L, Huether, S.E. (2019). Pathophysiology: The Biologic Basisfor Disease in Adults and Children. (8^th ed.). Mosby/Elsevier