Question

A 48-year-old premenopausal woman presents with fatigue and microcytic anaemia (haemoglobin 90 g/L, mean corpuscular volume 70 fL). Her ferritin is 6 µg/L. She reports heavy menstrual bleeding but no gastrointestinal symptoms. What is the most appropriate next step in evaluation?

Accepted Answer

Arrange colonoscopy to evaluate for lower gastrointestinal blood loss.

Answer

Begin oral iron therapy and assume menorrhagia is the sole cause without further investigation.

Answer

Order only faecal occult blood testing.

Answer

Start erythropoiesis-stimulating agents.

Answer

Observe without treatment or investigation.

Practice question

A 48-year-old premenopausal woman presents with fatigue and microcytic anaemia (haemoglobin 90 g/L, mean corpuscular volume 70 fL). Her ferritin is 6 µg/L. She reports heavy menstrual bleeding but no gastrointestinal symptoms. What is the most appropriate next step in evaluation?