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Iron Deficiency Anaemia — MRCGP AKT MCQ

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EasyHaematologyIron Deficiency AnaemiaMRCGP AKTMRCP Part 1UKMLAPARAPSA

A 69-year-old man presents with fatigue. His FBC shows: Hb 95 g/L, MCV 75 fL, Ferritin 8 µg/L. What is the most appropriate initial management?

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Correct answer: B — Oral ferrous sulfate 200mg TDS

The blood results show microcytic (low MCV) anaemia with low ferritin, confirming iron deficiency anaemia. According to CKS and NICE NG144, the first-line treatment for iron deficiency anaemia is oral iron supplementation, typically with ferrous sulfate 200mg two or three times daily (or equivalent). Blood transfusion is reserved for severe anaemia causing haemodynamic instability or severe symptoms. IV iron is considered if oral iron is ineffective, not tolerated, or rapid correction is needed. Folic acid or Vitamin B12 are for macrocytic anaemia. Investigating the underlying cause of the iron deficiency is also crucial, particularly in a man of this age (e.g., potential gastrointestinal blood loss).

Reference: CKS: Anaemia - iron deficiency / NICE NG144: Blood transfusion (principles of patient blood management)