- 28 year old female presented to the ED with increasing fatigue
- Fatigue started around 2-3 months ago and it’s progressively worsening. She denies any weakness, shortness of breath, dizziness, lightheadedness, or syncope. Last menstrual period was 2 weeks ago. Denies any heavy menstrual bleeding, denies any gastrointestinal bleeding or bleeding otherwise.
- Review of systems otherwise negative
- Type 2 Diabetes Mellitus, insulin-dependent
- Denies any tobacco or illicit drug use. Reports social alcohol consumption.
Temp: 37.2° C, BP: 115/72 mmHg, HR: 84 bpm, RR: 12 rpm, SpO2: 98% on room air
- No abnormalities
- CBC, CMP, PT/INR significant only for a hemoglobin of 7.2
- MCV is 102
- Reticulocytes are 1.3%
How would you work this up?