Emily is a 32-year-old Caucasian female. She

Emily is a 32-year-old Caucasian female. She presents to your clinic today with complaints of fatiguability, palpitations, and shortness of breath with activity. Emily works as a personal trainer and is captain of a local 5-K running group. Emily noticed mild symptoms about 3 months ago. Her symptoms have progressively worsened. Emily does not take any routine medications or supplements. She does not drink alcohol or smoke cigarettes. She does follow a Vegan diet plan. She denies any prior medical history. She does report long (8-9 day) heavy periods with clots, worsening since the birth of her last child 18 months ago. She denies any surgeries. She reports a recent abnormal desire to eat ice. Her review of systems (ROS) is negative. Her physical exam is unremarkable except: mild pallor of conjunctiva and mucous membranes and cracking in the corners of her mouth. Vitals: Blood Pressure: 100/56 Pulse: 90 Resp: 22 Oxygen Saturation: 96% room air Height: 62″ Weight: 121 lbs BMI: 22.1 You performed a complete blood count (CBC) today. The results were normal except for: RBC 4.28 Low HGB 9.7 Low HCT 29.9 Low MCV 69.7 Low MCH 22.6 Low MCHC 32.4 Low RDW 18.4 Low Questions What are some of your differential diagnoses in this case? What other information would you seek from this patient? What tests or diagnostic tools would you consider in this case, if any? What is your final diagnosis? What treatment and follow-up plan would you recommend in this case? What patient education would you provide this patient?

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