Question

A 42-year-old woman presents with fatigue. Laboratory tests show haemoglobin 88 g/L, mean corpuscular volume 68 fL, ferritin 6 µg/L, and normal B12 and folate. She reports heavy menstrual bleeding but no gastrointestinal symptoms. What is the most appropriate next step in management?

Accepted Answer

Start oral iron therapy and investigate for the cause of blood loss, beginning with gynaecological assessment

Answer

Reassure her that this is normal and repeat blood work in 1 year

Answer

Start long-term transfusions without iron

Answer

Start erythropoietin injections

Answer

Order bone marrow biopsy immediately

Practice question

A 42-year-old woman presents with fatigue. Laboratory tests show haemoglobin 88 g/L, mean corpuscular volume 68 fL, ferritin 6 µg/L, and normal B12 and folate. She reports heavy menstrual bleeding but no gastrointestinal symptoms. What is the most appropriate next step in management?