CASE STUDY 17 - Cindy Alaniz - Reproductive

Cindy Alaniz, age 25 years, has come to the health center to have her routine annual pap and pelvic examination. During her interview, she tells you that her menstrual periods are heavier than normal for the past 6 months and that she has been passing clots about the size of a nickel on the first day of each cycle. She denies any cramping with her menses. She is thinking about trying to become pregnant. Her medical history is negative for serious illness or surgery. Ms. Alaniz is currently taking no medications. She exercises but says that lately she has stopped this practice because she feels “tired all the time.” Her diet is high in pasta foods, some fruits, and vegetables, and she only eats meat once each month in an attempt to limit her fat content. She has episodes of dizziness, which she describes as “feeling very weak.” She also says she has been having some heart palpitations. The health care provider completes a physical examination and orders a complete blood count and differential.

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