Mrs R has betathalassemia major and has come into the office
     Mrs. R has beta-thalassemia major and has come into the office with an enlarged spleen, changes in the shapes of her facial bones, and jaundice.  As you take her history and examine her, what additional problems will you be watching for?  Choose the most likely problems that Mrs. R may develop.  Shortness of breath and activity intolerance  Bone fractures  Enlarged liver  Excessive bruising and bleeding  Elevated blood potassium  Collapsed lung  Weakness or fatigue  Constipation 
  
  Solution
The other symptoms are:
* Shortness of breath - due to inadequate cells that carry oxygen
* Enlarged liver
* Weakness and fatigue - due to inadequate oxygen supply
* Bone fractures - due to expansion of bone marrow, bones become thinner and brittle

