Woman Ironing

Primary and secondary colors, full intensity Rapt At Rappoport s, 1952 Primary and secondary colors, full intensity The Great Parade, 1954 Low intensity, neutrals Woman Ironing, 1904 Low intensity, neutrals La Place Rauignan, Still Life in Front of an Open Window, 1915 Low intensity, neutrals Chelsea Wharf Grey and Silver, 1875 Full intensity The Gate, 1960 Full intensity, neutrals Artist s Studio, 1974 Light and dark values Le Moulin de la Galette, 1879... 

Answer A. Pregnant woman with megaloblastic anemia and elevated serum homocysteine strongly suggests folate deficiency. Iron deficiency presents as microcytic, hypochromic anemia and would not elevate homocysteine. deficiency is not most likely in this presentation. 

It has been reported that one night a woman in New Jersey plugged her iron into an electrical outlet and then looked out the window to see all of the lights in New York City go out. She concluded it was her action that caused the blackout, and she called the power company to apologize for overloading the circuits. Comment. 

For mild anemia, the determination of red cell indices has some value in diagnosis however, it should be realized that these indices may appear to be entirely normal and that they are subject to errors. Patients with statistically normal hemoglobin values may show a positive hemoglobin response to iron therapy. A woman with hemoglobin concentration of 13g (100 ml)-1 may be iron deficient through excessive menstrual flow for her a hemoglobin concentration of 15g (100 ml)-1... 

A 47-year-old woman weighing 59 kg took acarbose 50 mg tds. Her blood glucose improved but she lost about 1 kg/month. She had a sore tongue without oral ulcers and no evidence of malabsorption. Later she developed general weakness and iron deficiency anemia but no other evidence of malabsorption. After she had lost 7 kg in 5 months, acarbose was withdrawn. Her complaints disappeared, her weight normalized, and she had no signs of iron deficiency anemia, even without iron therapy. 

A plump, middb-aged woman with immaculate iron-grey hair looked out at me. Yes ... 

Iron deficient or pregnant woman absorbs about 30% of dietary iron. 

A 30-year-old woman had a hemoglobin concentration of 3.1 g/dl, a mean cell volume of 77 fl, a reticulocyte count of 2.13%, a platelet count of 426 x 10 /1, a serum iron concentration of 5 ng/ml, a transferrin saturation of 1%, and a ferritin concentration of 8 ng/ml. She was intolerant of oral iron and was given intramuscular iron dextran, 100 mg/day for 8 days, when she developed asymptomatic thrombocytopenia (platelet count 20 X 10 /1). Iron dextran was withdrawn and she took oral ferrous fumarate 200 mg/day plus ascorbic acid 120 mg/day. Within 2 days her platelet count improved. 

An 80-year-old Japanese woman presented with epigastric discomfort and nausea. She had a history of hypertension, rheumatoid arthritis, iron deficiency anemia, chronic renal insufficiency, and had taken oral ferrous sulfite for 19 months. Endoscopic examination of the duodenum showed marked pigmentation of the duodenal mucosa. Histological examination showed that the pigment had histochemical features compatible with hemosiderin and was located mainly within macrophage lysosomes in the lamina propria. Ferrous sulfite was withdrawn and the pigmentation disappeared within 7 months. 

A 22-year-old woman with adult-onset Still s disease and massive hyperferritinemia became progressively more anemic, with a fall in hemoglobin to 8.2 g/dl, and was given oral ferrous fumarate 300 g bd (30). She developed acute florid hepatitis with an intraparenchy-matous histiocytic infiltration, which settled on withdrawal of the iron. 

The case once made against use of iron dextran in pregnancy because of a supposed risk of possible uterine cramps (SED-9, 377) or a greater risk of systemic reactions (SED-8, 513) has not been substantiated. However, in one case a pregnant woman had anaphylactic shock as a reaction to intravenous iron, and this resulted in fetal cerebral damage (SEDA-22, 246). 

The distribution of Tc-diphosphonate in bone was reportedly altered by circulating iron dextran complex in an elderly woman patient undergoing scintigraphy (59). 

A 46-year-old woman is prescribed doxycycline for a diagnosis of community-acquired pneumonia. Her PMH is significant for iron-deficiency anemia, peptic ulcer disease, HTN, a recent DVT, and headaches. Her current medications include ferrous sulfate, ibuprofen, enalapril, acetaminophen, famotidine, and warfarin. Which of her following medications is most likely to result in decreased levels of doxycycline ... 

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