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Iron deficiency anaemia in an older man — RACP Adult Medicine MCQ

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EasyHaematologyIron deficiency anaemia in an older manRACP Adult Medicine

A 67-year-old man has fatigue and microcytic anaemia. Ferritin is 8 microg/L and transferrin saturation is low. He has no overt bleeding and is not vegetarian. What is the most appropriate investigation?

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Correct answer: D — Bidirectional endoscopy to assess for gastrointestinal blood loss

Iron deficiency anaemia in an older man requires evaluation for gastrointestinal malignancy or other bleeding sources, commonly with gastroscopy and colonoscopy. Response to iron does not exclude cancer. Haemoglobinopathy testing, marrow biopsy and erythropoietin are not first-line in this scenario.

Reference: GESA/RACGP colorectal cancer guidance; AMH