Introduction
Pathophysiology refers to the study of abnormal or altered body functions due to a disease process. It entails the initiation, progression, and development of a disorder, with each of these manifesting by altering the body’s functions. When these essential body functions are altered, immune mechanisms are overwhelmed, leading to diseases. Therefore a disease depicts a disordered structure or function and usually produces specific signs and symptoms. This paper will handle and examine the patient’s symptoms with her diagnosis and explain implications to her health.
Discussion
Among the chief complaints of the 67-year-old is shortness of breath, fatigue, weakness, and feeling unsteady when she walks. These symptoms are seen in anaemia. Pasricha et al. (2018) suggest that anaemia is a condition whereby the body lacks enough red blood cells or has dysfunctional red blood cells. The result is reduced blood flow to the tissues, which leads to the paleness of the mucosal membranes and skin, fatigue, dizziness, and a fast heart rate. The patient’s examination supports the clinical suspicion of anaemia. The patient’s symptoms are pathognomic of anaemia. On physical examination, the patient is pale, she also has pale conjunctiva and palate, and her pulse rate is 118 beats per minute. There is also a systolic murmur depicting a fast heart rate seen in anaemia. Moreover, laboratory examination show results consistent with anaemia. This is depicted by a low hematocrit and a low hemoglobin concentration typical in anaemia. The reticulocyte count is high, also confirming anaemia as the body tries to achieve the normal hemoglobin level. A low mean corpuscular hemoglobin also supports the findings of anaemia. Mean corpuscular volume (MCV) is the measure of the volume of red blood cells. The average individual’s MCV range is 78g/L-100g/L as per Maner (2020). This MCV range determines if the anaemia is microcytic or macrocytic. Macrocytic anaemia is where the erythrocytes are larger than average that is greater than 100g/L, while microcytic anaemia is where the erythrocytes are small than average that is less than 78g/L. The mouth’s physical examination reveals a beefy red tongue, which is slightly swollen with normal rugae loss. This clinical sign of glossitis is suggestive of vitamin B12 deficiency. This finding is supported by laboratory findings of low levels of vitamin B12 in serum. This finding suggests megaloblastic anaemia is a differential diagnosis as per Hoffbrand (2015). Findings of a high MCV also support this diagnosis since macrocytic erythrocytes are typical of megaloblastic anaemia. Vitamin B12 deficiency can lead to nerve damage, thereby causing the feet’ numbness, as seen in the patient. The patient is hypothyroid from her past medical history. This can explain the unintentional weight loss, which could be a thyroid disorder. The low levels of thyroid hormones can interfere with ovulation, thereby impairing infertility. Other causes of infertility are sexually transmitted infections (STDs) such as chlamydia and gonorrhea. These are infections spread from person to another through intimate sexual contact. These infections require early recognition and treatment because they can spread to the uterus and oviduct. While in these parts, these organisms cause pelvic inflammatory disease (PID), which can lead to inflammation, blockage of the reproductive organs, and scarring. This will eventually cause infertility. STDs and pelvic inflammatory disease lead to the rise of inflammatory markers. Inflammatory markers are proteins released into the bloodstream by events that cause inflammation, such as infections. Therefore, acute phase proteins such as C- reactive protein, fibrinogen, ferritin levels in blood rise in STD, or PID events. Prostatitis and infections occur because of leakage of bacteria found in urine into the prostate. Systemic reaction, therefore, occurs due to the communication through the urethra, vas deferens, and ureter. In idiopathic thrombocytopenic purpura (ITP), thrombocytopenia can be due to splenic sequestration and peripheral destruction of platelets, according to Antel, Panieri & Novitzky (2015). Therefore splenectomy will help retain more platelets in circulation