John James is a 55 y/o man who had labs drawn prior to a ye…
John James is a 55 y/o man who had labs drawn prior to a yearly physical. He is here for followup of results from labs drawn 2 weeks prior. He has no complaints except for occasional fatigue. His CBC and an anemia panel reveals the following: Hemoglobin (Hb): 9.2 g/dL (Normal range for age: 11.0 – 13.5 g/dL Mean corpuscular volume (MCV): 68 fL (Normal range for age: 76 – 92 fL) Mean corpuscular hemoglobin concentration (MCHC): low value Serum ferritin: 6 ng/mL (Normal range for age: 12 – 120 ng/mL) Serum iron: 15 µg/dL (Normal range for age: 40 – 100 µg/dL) Total iron-binding capacity (TIBC):490 µg/dL (Normal range for age: 250 – 450 µg/dL) 1-Based on the MCV and MCHC- What type of anemia is this and why does this anemia cause a low MCV? (2 points) 2-What lab reflects iron stores? (1) 3-Why is the TIBC high? (1) 4- List at least 2 possible differentials that may be causing his anemia. (1)