Increasing Tiredness And Shortness Of Breath In A Female

A 39-year-old female is admitted to the hospital complaining increasing tiredness and shortness of breath for three months with frequent headaches. Her periods occur every 24 days and the first day is moderate, but second to the fourth day are very heavy. She uses tampons and sanitary towels together. She has no pain.

Her last smear test was normal about 2 years ago. She had no gynaecological problems before and takes no medicine. Physical examination revealed The women is slim with pale conjunctivae Abdominal, bimanual and spectrum examinations are remarkable  Blood profile Haemoglobin                  6.3g/dl Mean cell volume           66fL White cell counts           9.1x109/L Platelets                       300x109/L Ferritin                          9µg/L  Iron                              7µmol/L  Total iron binding capacity (TIBC)  80µmol/L Transvaginal ultrasound scan report…