Mr Fitts iron deficiency anemia case study guide
A 72-year-old widower, lethargic on a coffee-and-donut diet, with a microcytic hypochromic lab panel: seven questions from interpreting every value through cause, treatment, dietary teaching, supplement counseling and the parameters that prove resolution.
Editorial process
Last reviewed · August 12, 2026
What does Mr. Fitts's lab pattern say, value by value?
The lab panel is the case's spine and question one wants it read value by value, in the questioner's own generous phrasing: say what is abnormal, what is normal, and what each abnormality is attributable to. The pattern is built to be recognized — RBC, hemoglobin at 8.3 and hematocrit at 24 percent all low; MCV at 73 and MCH at 23 marking the anemia as microcytic and hypochromic; iron at 28 and ferritin at 14 confirming depleted stores; and, just as deliberately, cobalamin at 600 and folate at 10 sitting normal, planted so you can rule the macrocytic causes out loud. The white count and platelets are normal too, and saying so matters: the interpretation question explicitly grades the normals, because recognizing what is not wrong is half of reading a panel. Question two then walks back through the history with the diagnosis in hand — the fatigue, exertional dyspnea, palpitations with a resting pulse of 98, and the 92 percent saturation are the compensations and manifestations of anemia this patient is actually showing.
The cause question is where the case's story does the work: a 72-year-old widower whose wife cooked for him, now living on coffee, a donut, a hot dog and a jelly sandwich — a diet with essentially no absorbable iron — six months into bereavement with poor intake and weight loss. Dietary insufficiency is the probable cause the case constructs, and the honest answer also notes what a provider must still consider in a 72-year-old male with iron deficiency: occult gastrointestinal loss is the standard rule-out at this age, and acknowledging it in a sentence shows clinical maturity without fighting the case's framing. (The stray 'D.G.' in question three is a template artifact from the case's source; it means Mr. Fitts.) Treatment follows standard lines — oral iron replacement, dietary correction, and treating the underlying cause, which here includes the nutritional and psychosocial situation of a grieving man who does not cook.
The teaching questions reward specificity the prompt explicitly demands: dietary sources should span heme iron (lean red meat, poultry, fish) and non-heme sources (beans, lentils, fortified cereals, dark leafy greens) with the vitamin-C-enhances-absorption pairing; the supplement question wants the practical counseling points named — take on an empty stomach or with orange juice, not with coffee, tea, milk or antacids, expect constipation and dark stools, and continue for months after the hemoglobin corrects to rebuild ferritin stores. The evaluation question closes the loop with the same instrument the case opened with: reticulocytosis within one to two weeks as the earliest signal, hemoglobin and hematocrit rising over weeks, ferritin recovering last — paired with the assessment findings you would expect to lift: energy, dyspnea, the resting heart rate and saturation. Answer all seven in order, each labeled, with the panel's own numbers cited back — this case grades whether you can make the data speak.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Interpret a complete panel including the deliberate normals — cobalamin, folate, WBC, platelets — with attributions for each abnormality.
- 02Map the history's fatigue, dyspnea, palpitations and saturation onto anemia's compensatory physiology.
- 03Argue dietary insufficiency as the constructed cause while acknowledging the age-appropriate GI rule-out.
- 04Deliver treatment and teaching at counseling-point specificity: sources, absorption pairings, side effects, duration.
- 05Define resolution parameters in labs (reticulocytes first, ferritin last) and assessment findings.
Read the full question
Review every instruction before using the planning guidance that follows.
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Turn the brief into deliverables
- 01All seven questions answered in order and labeled.
- 02A value-by-value lab interpretation covering abnormals with attributions and normals acknowledged.
- 03Clinical manifestations drawn from this case's own subjective and objective data.
- 04Treatment, dietary sources, and specific oral-iron counseling points (what to take them with; side effects).
- 05Evaluative parameters for resolution, specific to labs and assessment findings.
How do the seven questions chain from panel to resolution?
The panel, read completely
Interpret each value: the low RBC, hemoglobin and hematocrit; the microcytic hypochromic indices; depleted iron and ferritin; and the normal cobalamin, folate, WBC and platelets — with what each abnormality is attributed to.
The patient the panel predicts
Match the history to the diagnosis: fatigue, exertional dyspnea, palpitations at a resting pulse of 98, weight loss, and the 92 percent saturation as anemia's compensations.
The cause the case built
Explain iron deficiency anemia's mechanism and argue the probable cause: a bereaved man's iron-empty diet — with the age-appropriate note that occult GI loss remains the standard rule-out.
Treatment and the teaching pair
Cover oral iron replacement and dietary correction, then the two teaching questions: heme and non-heme sources with absorption pairings, and the specific supplement counseling points the prompt demands.
Proving resolution
Name the evaluative parameters: reticulocytosis first, hemoglobin and hematocrit rising, ferritin recovering last, and the assessment findings — energy, dyspnea, pulse, saturation — expected to improve.
Where are iron deficiency's mechanisms and teaching points?
Recommended databases
- NHLBI
- NCBI Bookshelf / StatPearls
- MedlinePlus
Search sequence
- 1.Review the iron-deficiency reference for the microcytic hypochromic pattern and iron-study interpretation.
- 2.Check the federal overview for treatment and monitoring standards.
- 3.Confirm the supplement counseling specifics — absorption enhancers and inhibitors, side effects, duration — before writing the teaching answers.
- 4.Write the resolution answer from the reticulocyte-first, ferritin-last sequence.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Iron-Deficiency Anemia
National Heart, Lung, and Blood Institute, NIH · 2024
The condition's authoritative overview — causes, treatment and monitoring — behind questions three, four and seven.
- 02
Iron Deficiency and Microcytic Hypochromic Anemia
StatPearls, NCBI Bookshelf · 2024
The lab-interpretation machinery: the microcytic hypochromic indices, iron studies and the differential logic the planted normal B12 and folate exist to trigger.
- 03
Anemia
MedlinePlus, U.S. National Library of Medicine · 2024
The patient-facing framing for the teaching questions — dietary sources and supplement guidance in the language Mr. Fitts's education would actually use.
Review before submission
Common mistakes
- Interpreting only the abnormal values when question one explicitly asks for the normals too.
- Missing the planted rule-outs — normal cobalamin and folate exist so you can exclude macrocytic causes explicitly.
- Naming manifestations from the textbook instead of this chart: his pulse of 98, saturation of 92, and exertional symptoms.
- Stopping at dietary cause without the sentence acknowledging occult GI loss as the standard rule-out at 72.
- Vague supplement teaching when the question demands specifics: empty stomach, vitamin C, not with coffee or milk, constipation, dark stools, months of continuation.
- Forgetting reticulocytes as the earliest resolution signal, and ferritin as the last to recover.
Submission checklist
- Seven labeled answers in order.
- Every panel value addressed — abnormal with attribution, normal acknowledged.
- Manifestations tied to this chart's numbers.
- Cause argued from the diet story with the GI rule-out noted.
- Teaching at counseling-point specificity; resolution parameters name reticulocytes, H/H trajectory, ferritin, and assessment findings.
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