Question

A 45-year-old vegetarian woman presents with fatigue and pallor. Blood tests show Hb 9.0 g/dL, MCV 72 fL, ferritin low and transferrin saturation reduced. She has no menstrual periods due to endometrial ablation. What is the most appropriate next step in management?

Accepted Answer

Investigate for gastrointestinal blood loss and start oral Iron

Answer

Reassure that this is dietary and give Iron only

Answer

Start Vitamin B12 injections

Answer

Arrange urgent bone marrow biopsy

Answer

Start Prednisolone for presumed autoimmune haemolysis

Practice question

A 45-year-old vegetarian woman presents with fatigue and pallor. Blood tests show Hb 9.0 g/dL, MCV 72 fL, ferritin low and transferrin saturation reduced. She has no menstrual periods due to endometrial ablation. What is the most appropriate next step in management?