A 28-year-old female presents to her outpatient department with complaints of persistent fatigue,

weakness, and shortness of breath. She reports that these symptoms have been gradually worsening

over the past few months. She also mentions that she has experienced heavy menstrual bleeding for

the last several years. A physical examination reveals pale conjunctiva and nails. A complete blood

count (CBC) is ordered, and the results show a hemoglobin level of 9 g/dL, with microcytic and

hypochromic red blood cells. The physician concluded that the patient had iron deficiency anaemia.

Write a rational prescription for the above condition.

[Doctor's Name] [Date]

[Address]

[City, State, PIN Code]

[Phone Number]

[Email Address

[Patient's Full Name]

Age/sex:

Address:

City, State, pin Code:

1. Tab. Ferrous Sulfate 200 mg ------------------------------------------------------90 tablets

Sig: One tablet to be taken orally once daily x 3 months

2. Tab. Vitamin C 100 mg -------------------------------------------------------------90 tablets

One tablet to be taken orally once daily x 3 months

Advice:-
  Follow up after 3 months

 Take the iron supplement with a full glass of water on an empty stomach.

[Doctor's Signature]

[Doctor's Printed Name]

A 50-year-old male, presented to his primary care physician with complaints of fatigue, weakness, and

tingling sensations in his hands and feet for the past several months. He mentioned a history of a

vegetarian diet and occasional alcohol consumption. A physical examination revealed pale

conjunctiva and glossitis. His physician ordered blood tests.

Blood Reports:

1. Complete Blood Count (CBC):

 Hemoglobin (Hb): 8.5 g/dL (Reference Range: 13.5 - 17.5 g/dL)

 Mean Corpuscular Volume (MCV): 115 fL (Reference Range: 80 - 100 fL)

 White Blood Cell Count (WBC): 6.5 x 10^3/μL (Reference Range: 4.0 - 11.0 x

10^3/μL)

 Platelet Count: 210 x 10^3/μL (Reference Range: 150 - 450 x 10^3/μL)

2. Peripheral Blood Smear:

 Macrocytic and hypersegmented neutrophils

3. Serum Vitamin B12: 150 pg/mL (Reference Range: 200 - 900 pg/mL)

4. Serum Folate: 2 ng/mL (Reference Range: 3 - 17 ng/mL)

5. Methylmalonic Acid (MMA): Elevated

6. Homocysteine: Elevated
He was diagnosed as a case of Megaloblastic anaemia. Write a rational prescription regarding

treatment of this condition.

[Doctor's Name] [Date]

[Address]

[City, State, PIN Code]

[Phone Number]

[Email Address]

[Patient's Full Name]

Age/sex:

Address:

City, State, pin Code:

1. Tab. Ferrous Sulfate 200 mg --------------------------------------------90 tablets

Sig: One tablet to be taken orally once daily x 3 months

2. Tab. Vitamin C 100 mg---------------------------------------------------90 tablets

Sig: One tablet to be taken orally once daily x 3 months

3. Tab Vitamin B12 1000 mcg ------------------------------------------------90 tablets

Sig: One tablet orally once daily x 3months

4. Tab. Folic Acid 1 mg -------------------------------------------------------90 tablets sig:

One tablet orally once daily x 3 months

Advice:-

 Follow up after 3 months

 Take the iron supplement with a full glass of water on an empty stomach

[Doctor's Signature]

[Doctor's Printed Name]

A 35-year-old woman, living in a rural area with poor sanitation, presented to a clinic with complaints

of fatigue, weakness, and shortness of breath for the past few months. She mentioned that she often

walks barefoot in the fields and works as a farmer. On physical examination, she appeared pale, and a

complete blood count (CBC) was conducted.

Blood Reports:

1. Hemoglobin (Hb): 8.0 g/dL (Reference Range: 12.0 - 15.0 g/dL)

2. Mean Corpuscular Volume (MCV): 75 fL (Reference Range: 80 - 100 fL)

3. White Blood Cell Count (WBC): 6.0 x 10^3/μL (Reference Range: 4.0 - 11.0 x 10^3/μL)

4. Red Blood Cell Count (RBC): 4.5 x 10^6/μL (Reference Range: 4.5 - 5.5 x 10^6/μL)

5. Platelet Count: 220 x 10^3/μL (Reference Range: 150 - 450 x 10^3/μL)

6. Peripheral Blood Smear: Microcytic, hypochromic red blood cells

7. Stool Examination: Detected hookworm eggs.

The most likely diagnosis for this condition is hookworm-related anemia, specifically caused by the

hookworm parasite Necator americanus or Ancylostoma duodenale.

[Doctor's Name] [Date]

[Address]
[City, State, ZIP Code]

[Phone Number]

[Email Address]

[Patient's Full Name]

Age/sex:

Address:

City, State, pin Code:

1. Tab. Ferrous Sulfate 200 mg -----------------------------------------------90 tablets

Sig: One tablet to be taken orally once daily x 3 months

2. Tab. Vitamin C 100 mg ---------------------------------------------------90 tablets

Sig: One tablet to be taken orally once daily x 3 months

3. Tab. Albendazole 400mg------------------------------------------------------2 tablets

Sig: - 1 tab stat orally on empty stomach and one after 15 days

4. Tab. Pyrantel pamoate 500mg-----------------------------------------------2 tablets

Sig: - 1 tablet stat orally on empty stomach and one after 15 days

Advice: -

 Follow up after 3 months

 Take the iron supplement with a full glass of water on an empty stomach

 Maintain hygiene
 [Doctor's Signature]

[Doctor's Printed Name]

A 40-year-old woman, presented to the emergency department with sudden-onset swelling, pain, and

redness in her left leg. She mentioned that she had recently been on a long-haul flight and had a

family history of deep vein thrombosis (DVT). A Doppler ultrasound confirmed the presence of a

DVT in her left lower limb. The physician has decided to start her on anticoagulant therapy. She has a

weight of 45kg. Write a rational prescription for the same.

[Doctor's Name] [Date]

[Address]

[City, State, PIN Code]

[Phone Number]

[Email Address]

[Patient's Full Name]

Age/sex:

Address:

City, State, pin Code:

1. Inj. Enoxaparin 100mg/ml---------------------------------7 vials

Sig: 45mg SC twice daily x 7 days

2. Tab. Warfarin 5mg-------------------------------------------10 tablets

 Sig: 1 tablet once daily after food x to continue

Advice:-

 Review after 1 week with INR report

[Doctor's Signature]

[Doctor's Printed Name]

A 35-year-old female of 50 kg weight with a history of heavy menstrual bleeding, which has been

ongoing for several years. She experienced fatigue, weakness, and shortness of breath, which

prompted her to seek medical attention.

Initial Assessment: Upon presentation, the physician conducted a physical examination and ordered

blood tests, including a complete blood count (CBC) and iron studies. The results of her initial

assessment were as follows:

 Haemoglobin (Hb): 8.5 g/dL (normal range: 12-15.5 g/dL)

 Haematocrit (Hct): 28% (normal range: 36-46%)

 Mean Corpuscular Volume (MCV): 62 fL (normal range: 80-100 fL)

 Serum Iron: 20 µg/dL (normal range: 50-170 µg/dL)

 Ferritin: 5 ng/mL (normal range: 12-150 ng/mL)

 Total Iron-Binding Capacity (TIBC): 350 µg/dL (normal range: 250-450 µg/dL)

 Transferrin Saturation: 6% (normal range: 20-50%)

The patient was unresponsive to oral iron therapy and was advised intravenous iron. Write a

prescription for the same.

[Doctor's Name] [Date]

[Address]

[City, State, ZIP Code]

[Phone Number]

[Email Address

[Patient's Full Name]

Age/sex:

Address:

City, State, pin Code:

1. Inj. Iron Dextran 50mg/ml ---------------------------------------------------------15 vials

Sig: 1 vial intravenously four times in a week on alternate days x 4 weeks

Advice: -

 Follow up after 1 month

[Doctor's Signature]

[Doctor's Printed Name]

Notes: -
Formula for calculation:

Iron requirement(mg)= 4.4x body wt(kg) x Hb deficit(g/dl)= 4.4 x 50 x (desired Hb- observed Hb)

= 4.4 x50 x (14.8-8.5)

= 4.4 x50 x 6.3

= 1386 mg

Now, iron dextran comes in the formulation of 50mg/ml

Hence, for 1386mg, we will require= (1386/50) ml = 27.72 or rounded to 30ml

Now, Each vial of iron dextran has 2 ml. so for 30ml we need 15 vials, which has to be given on

alternate days with 24 hour gap in between. So the time required for the completion of this regimen is

30 days or 1 month or 4 weeks.