Snapshot A 26 year-old woman presents to her primary care physician with 4 months of fatigue. She reports feeling tired throughout the day and exercise intolerance. On review of symptoms, she reports menorrhagia. On exam, she is mildly tachycardic with pale skin and conjunctiva. Introduction Defined as deficiency in circulating RBC mass Several types microcytic MCV < 80 seen in disorders of hemoglobin metabolism normocytic MCV 80-100 seen in disorders of RBC production or destruction macrocytic MCV > 100 seen in folate, B12 deficiency Presentation Symptoms weakness/fatigue dyspnea headache/lightheadedness angina Presentation tachycardia pale conjunctiva/skin