Question

A 58-year-old woman with a BMI of 30 kg/m² presents with tiredness and dyspnoea on exertion. Her haemoglobin is 90 g/L, MCV 70 fL and ferritin is 8 micrograms/L. She is postmenopausal and has no overt bleeding. What is the most appropriate next step in addition to starting iron replacement?

Accepted Answer

Screen for coeliac disease and arrange colonoscopy to assess for gastrointestinal blood loss

Answer

Reassure and attribute anaemia to diet alone

Answer

Offer hysterectomy

Answer

Commence erythropoiesis-stimulating agents

Answer

Delay investigations until iron therapy has normalised haemoglobin

Practice question

A 58-year-old woman with a BMI of 30 kg/m² presents with tiredness and dyspnoea on exertion. Her haemoglobin is 90 g/L, MCV 70 fL and ferritin is 8 micrograms/L. She is postmenopausal and has no overt bleeding. What is the most appropriate next step in addition to starting iron replacement?