A 56-year-old man with rheumatoid arthritis on long-term NSAIDs presents with fatigue and exertional breathlessness. FBC shows haemoglobin 98 g/L, MCV...

Question

A 56-year-old man with rheumatoid arthritis on long-term NSAIDs presents with fatigue and exertional breathlessness. FBC shows haemoglobin 98 g/L, MCV 74 fL and low ferritin. He also reports intermittent dark stools. What is the most appropriate initial investigation in addition to iron replacement?

Accepted Answer

Urgent gastrointestinal investigation for occult blood loss

Answer

Bone marrow biopsy

Answer

Serum vitamin B12 and folate only

Answer

No further investigation; treat as simple dietary deficiency

Answer

Haemoglobin electrophoresis

uk-plab-1 MCQ (SBA): Iron deficiency anaemia (occult GI loss)