Question

A 70-year-old woman presents with progressive fatigue. Hb is 88 g/L, MCV 70 fL, ferritin 6 µg/L and transferrin saturation 7%. She takes no NSAIDs. What is the most appropriate next investigation in this context?

Accepted Answer

Colonoscopy and upper GI endoscopy to evaluate for occult bleeding

Answer

Coeliac serology only

Answer

Start oral iron and no further investigation is needed

Answer

Bone marrow biopsy to exclude myelodysplasia

Answer

Abdominal ultrasound to assess for splenomegaly

Practice question

A 70-year-old woman presents with progressive fatigue. Hb is 88 g/L, MCV 70 fL, ferritin 6 µg/L and transferrin saturation 7%. She takes no NSAIDs. What is the most appropriate next investigation in this context?