Question

A 58-year-old woman is found to have microcytic anemia on routine labs. Hemoglobin is 9.8 g/dL, MCV 72 fL, ferritin 8 ng/mL, and transferrin saturation 10%. She has no overt bleeding and is postmenopausal. Which is the most appropriate next diagnostic step?

Accepted Answer

Arrange upper endoscopy only.

Answer

Start oral iron and recheck labs in 6 months without further evaluation.

Answer

Arrange colonoscopy to evaluate for occult gastrointestinal blood loss.

Answer

Order hemoglobin electrophoresis only.

Answer

Reassure her that this is likely due to diet and observe.

Practice question

A 58-year-old woman is found to have microcytic anemia on routine labs. Hemoglobin is 9.8 g/dL, MCV 72 fL, ferritin 8 ng/mL, and transferrin saturation 10%. She has no overt bleeding and is postmenopausal. Which is the most appropriate next diagnostic step?