Gastroenterology · SBA · Tutor mode
A 62-year-old man presents with three months of fatigue. Full blood count shows haemoglobin 96 g/L with microcytosis, and ferritin is 8 µg/L. He takes no regular medications and reports no overt bleeding.
Which is the most appropriate next step in management?
- AOral iron replacement and review in three months
- BFaecal occult blood testing
- CReferral for gastroscopy and colonoscopy
- DBlood film examination
- ETrial of a proton pump inhibitor
Correct — Explanation
Unexplained iron-deficiency anaemia in a man of this age requires bidirectional endoscopy to exclude gastrointestinal malignancy. Replacing iron without investigation risks delaying the diagnosis.
Learning point: Iron-deficiency anaemia in an adult man is a red flag for GI blood loss until proven otherwise.