Iron deficiency anemia Quiz: Ace Your Exams
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A 42-year-old woman presents for a follow-up of iron deficiency anemia secondary to menorrhagia. She has been taking oral iron supplementation (ferrous sulfate once daily) for 8 weeks. Her initial hemoglobin was 7.8 g/dL, serum iron was 28 μg/dL and ferritin was 8 ng/mL. She has been taking the medication as prescribed, on an empty stomach, and without food. She has been experiencing intermittent nausea, bloating, and constipation. Medical history is significant for uterine fibroids. Temperature is 36.8°C (98.2°F), pulse is 104/minute, respiratory rate is 16/minute, blood pressure is 118/78 mmHg, and oxygen saturation is 97% on room air. Physical examination shows conjunctival pallor and pale nail beds. Cardiac examination shows tachycardia with regular rhythm. Lungs are clear to auscultation bilaterally. Laboratory results are shown below. Which of the following is the best next step in management?
| Laboratory value | Result | Reference |
| Hemoglobin | 8.0 g/dL | 13.5 - 17.5 g/dL |
| Hematocrit | 38 % | 41 - 53% |
| MCV | 76 fL | 80 - 100 fL |
| Iron | 30 μg/dL | 50 - 170 μg/dL |
| Ferritin | 10 ng/mL | 15 - 200 ng/mL |
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