A 62-year-old elderly woman, Mrs. NM, comes into the emergency room with a Chief Complaint of…

A 62-year-old elderly woman, Mrs. NM, comes into the emergency
room with a Chief Complaint of generalized weakness and moderate
shortness of breath, with heavy epistaxis for the past 20 hours.
The patient also related that she had bitten the inside of her
mouth about 1 week ago, and she still had mild, occasional bleeding
from the site, despite being extremely careful with chewing food
and brushing teeth. Pt. also stated that she sometimes her stools
are very dark, but stated that she eats beets every night. Pt.
reported a recent upper respiratory infection, which she went to
see her Primary Care Physician for, who prescribed Bactrim for 7
days, which she completed two days ago. Pt. denied any changes in
Pt. history includes, Breast Cancer (2 years ago), Diabetes
Miletus, Hyperlipidemia, and High Blood Pressure.
Surgery history includes Right Breast Mastectomy.
Current reported Medications: Tamoxifen,  Glyburide
2.5 mg BID, Atorvastatin 20 mg QHS, Norvasc 5 mg BID
Pt. denies smoking, drinking, and/or illicit drug use
Pt. denied use of any herbal and/or over the counter
On Physical Examination, the patient was an elderly woman with
no apparent distress but obviously weak. Height and weight were
appropriate for age. Multiple attempts for BP on the right arm
revealed 90/55. Oxygen Saturation: 95% on room air. Pt. was
afebrile. Lungs were clear to auscultation. Neurological evaluation
was normal. Skin was dry and turgor was reduced. There was a round,
inflamed lesion of dried blood located on the right buccal mucosa.
Skin revealed diffuse petechial on the bilateral upper and lower
extremities, as well as across the lower abdomen.
Laboratory work-up:
Basic Metabolic Panel: Within in normal limits
White Blood Cell: 8 μL
Hgb: 7.1 g/dL
Hct: 21.2 %
Platelet count: 50,000 mm3
1. What are the causes of this suspected disease process?
2. What dietary recommendation would you include for this
patient? Give examples.