What do you now think is happening?

What remains uncertain?

What is your leading working explanation?

Sprint 02: The Number That Changes the Visit

learner_id

identity_provenance

Stress, inadequate sleep, and inconsistent nutrition

Iron-deficiency anemia or another hematologic process

Menstrual history, including flow and recent changes

Functional or exertional symptoms, including palpitations, dyspnea, or reduced exercise tolerance

Focused examination for pallor, volume status, and cardiovascular findings

Initial laboratory evaluation guided by the emerging differential

Before deciding what this represents, which areas should you prioritize next? Choose up to four.

Build the encounter feedback

Compare your reasoning

Begin treatment for presumed iron deficiency and arrange outpatient follow-up—heavy menstrual bleeding provides a likely explanation and she is comfortable at rest.

Complete a broader outpatient fatigue workup before changing disposition because the precise cause of anemia is not yet established.

Confirm anemia severity, further evaluate the bleeding source, assess for physiologic compromise, and let her symptoms and stability guide disposition.

Prioritize gynecologic evaluation of the bleeding source and defer anemia assessment until the source is clarified.

Escalate immediately for transfusion because a hemoglobin below 8 g/dL alone establishes the need for emergency treatment.