Question

A 56-year-old woman presents with fatigue and dyspnea on exertion. CBC shows Hb 8.5 g/dL, MCV 70 fL, and ferritin 6 ng/mL. She has heavy menstrual bleeding but no GI symptoms. Which is the most appropriate initial diagnostic approach?

Accepted Answer

Obtain colonoscopy and upper endoscopy if indicated

Answer

Begin oral iron and no further evaluation

Answer

Refer for upper endoscopy only

Answer

Order bone marrow biopsy

Answer

Order CT abdomen and pelvis

Practice question

A 56-year-old woman presents with fatigue and dyspnea on exertion. CBC shows Hb 8.5 g/dL, MCV 70 fL, and ferritin 6 ng/mL. She has heavy menstrual bleeding but no GI symptoms. Which is the most appropriate initial diagnostic approach?