Question

A 34-year-old premenopausal woman presents with fatigue and exertional dyspnoea. Full blood examination shows Hb 94 g/L, MCV 70 fL and low ferritin. She reports heavy menstrual bleeding but no gastrointestinal symptoms. What is the most appropriate initial management?

Accepted Answer

Start oral iron supplementation and investigate menstrual bleeding

Answer

Refer immediately for colonoscopy without iron therapy

Answer

Observe without treatment as anaemia is mild

Answer

Start erythropoietin injections

Answer

Arrange urgent bone marrow biopsy

Practice question

A 34-year-old premenopausal woman presents with fatigue and exertional dyspnoea. Full blood examination shows Hb 94 g/L, MCV 70 fL and low ferritin. She reports heavy menstrual bleeding but no gastrointestinal symptoms. What is the most appropriate initial management?