A 60 yr old female with history 8 blood transfusions in 2yrs. Her Hb-60g/L, TLC-5800, platelet- 3.4 lakhs, MCV-60, RBC-2.1 lakhs/mm3. She is having hypochromic microcytic anemia. Which investigation is not needed?
Ans. is 'a' i.e.,Evaluation of pulmonary hemosiderosis Anemia with low RBC count, microcytosis and hypochromia point towards iron deficiency anemia. o Bone marrow examination is indicated :- "Bone marrow biopsy" in iron deficiency anemia demonstrates erythroid hyperplasia and micronormoblasts reaction. Prussian blue staining of the bone marrow aspirate and smear and biopsy demonstrates absence of iron stores. o The patient continues to have iron deficiency anemia despite the blood transfusions. GI endoscopy may be indicated to rule out GIT pathology as chronic blood loss may result from GIT ( malena, hematemesis). Urine examination may be indicated to see hemosiderin in urine because chronic blood loss may also result from hemolytic anemia ( eg Paroxysmal nocturnal hemoglobinuria).
Evaluation for pulmonary hemosisderosis
Urinary hemosiderin
Bone marrow examination
GI endoscopy