21st July 2023

A 90-year-old woman presents to an urgent care centre with a 6-month history of gradually worsening fatigue

A 90-year-old woman presents to an urgent care centre with a 6-month history of gradually worsening fatigue associated with worsening shortness of breath on exertion. Her past medical history includes Raynaud’s phenomenon, GORD and hyperlipidaemia. She takes omeprazole 20mg OD and atorvastatin 20mg ON and has no known medication allergies. Full clinical examination reveals pale conjunctiva but is otherwise unremarkable. Blood tests show a microcytic anaemia (haemoglobin – 85, MCV – 73) with low iron levels (4) and ferritin levels (23). Renal function, liver function and inflammatory markers are normal. She is referred for endoscopy. Upper GI endoscopy is undertaken which reveals a small uncomplicated gastric ulcer. Helicobacter pylori testing during endoscopy is negative.

What is the next stage in the management of this woman’s microcytic anaemia?

Select the SINGLE most appropriate option from the list below. Select ONE option only.