Microcytic & Normocytic anemia

A middle-aged female presented with swallowing difficulties, and examination revealed severe pallor, glossitis, and deformed nails. What is the recommended initial treatment for her?

A young female visited the outpatient department (OPD) with complaints of persistent fatigue and exertional shortness of breath over the past two weeks. Her CBC revealed a hemoglobin level of 8.9 g/dL, MCV of 65 fL, and an elevated eosinophil count. What is the likely underlying cause of her anemia?

During the second follow-up of a pregnant woman, her investigation results indicated a hemoglobin level of 10, a mean corpuscular volume (MCV) of 59, a normal red cell distribution width (RDW), and a high total red blood cell (RBC) count. What is the diagnosis?

An 18-year-old male presented with jaundice and hepatosplenomegaly. He underwent a blood transfusion a week ago, and he has a long history of multiple transfusions since childhood. A blood film shows normocytic normochromic anemia. What is the likely diagnosis?

A patient received laboratory results indicating anemia. He is a known case of rheumatoid arthritis, and anemia of chronic disease is suspected. What peripheral blood film finding is expected in this scenario?

A middle-aged female presented with fatigue and pallor. Her investigations showed

• Hemoglobin:9.8 g/dL, MCV of 70, MCH of 30
• WBC count: 8000
• Platelet count: 345,000
• Reticulocytes: 1.56
• Serum iron: Below the lower limit of normal
• Serum Ferritin: 350 (high)
• Hepcidin: elevated.

What is the likely diagnosis?

A 38-year-old female presents with a 6-month history of worsening pain and swelling in her hands and feet. She describes profound stiffness in the mornings that lasts 2 hours. She has been self-medicating with various over-the-counter painkillers and local balms with minimal relief. On examination, there is symmetrical boggy swelling and tenderness of the 2nd and 3rd metacarpophalangeal (MCP) joints, the proximal interphalangeal (PIP) joints, and both wrists. Her gait is antalgic due to involvement of the metatarsophalangeal (MTP) joints. There is no malar rash, oral ulcers, or photosensitivity.

Laboratory Investigations:

• Hemoglobin: 8 g/dL (MCV: 82 fL)
• TLC: 11,500
• Platelet Count: 480,000
• Serum Iron: 35 mcg/dL (Normal: 50–170)
• Total Iron Binding Capacity (TIBC): 210 mcg/dL (Normal: 250–450)
• Serum Ferritin: 410 ng/mL (Normal: 15–150)

Which of the following is the most appropriate next step in the management of this patient’s anemia?