Anemia:
A 44-year-old male presents to your clinic with a chief complaint of fatigue. He states that he has never smoked in his life but he does drink on social occasions. His past medical history is insignificant. His blood pressure is 120/70 mmHg and his heart rate is 86/min. Physical examination is insignificant. Laboratory study shows:
Hemoglobin…………….. 7.6 g/dL
MCV ……………………… 71 fL
MCHC …………………… 27%
Leukocyte count ………… 7,800/cmm
ESR ………………………. 15 mm/hr
Serum iron and ferritin levels are decreased. What is the next best step in management of this patient?
A] Iron supplementation
B] Work up for Malabsorption
C] Bone marrow sampling
D] Test of occult blood in the stool
E] Dietary modification
F] Blood transfusion
G] Hemoglobin electrophoresis
[expand title=”CLICK HERE to view the correct answer:”][sociallocker]This patient presents with hypochromic/microcytic anemia accompanied with depressed serum iron and ferritin levels. Such a clinical picture is typical for iron-deficiency anemia. The most common cause of iron deficiency anemia is chronic blood loss. Discovery of iron deficiency anemia in an adult male or a post-menopausal woman should prompt the physician to look for gastrointestinal cause of blood loss. Tests for occult blood in the stool should be done first. It is not unusual for right-sided colon cancer to manifest as iron deficiency anemia. Other gastrointestinal causes of chronic blood loss may include peptic ulcer disease, angiodysplasia, colonic diverticula, etc.[/sociallocker][/expand]