FPS Quiz (Beasley) for Facebook

A 50 year old gentleman comes into the office. He has been feeling tired for the past 2 weeks, and notes he has had a few dark colored stools. Past history includes intermittent GERD, and chronic intermittent lower back pain for which he takes “some pain powders” as needed. He works in landscaping, and notes maybe 3 beers a day. His blood pressure is 130/70, and he has mild epigastric tenderness on exam. Point of care testing shows positive hemoccult and a hemoglobin of 6.8. His largest risk factor for peptic ulcer disease is:

After hospitalization and transfusion of 2 units, our gentleman has a stable hemoglobin of 9.0 and feels well. The GI consultant has performed an EGD and colonoscopy, and they found mild gastritis with a non bleeding area of ulceration. H pylori is pending. He is counseled on NSAID avoidance, including powders, and placed on a PPI. Moments before discharge, you note his MCV is 76 and wonder if you should do something more. The best course of action involves which of the following thoughts:

His MCV is nearly normal, and a CBC can be monitored as an outpatient.

An H2 Blocker will be better tolerated, and as effective as PPI

He should be discharged on a multivitamin

Iron studies should be checked

He will benefit from 1 more unit of blood

Your gentleman has iron studies resulted, and you are trying to interpret them and discharge him home. The best indicator for IDA (iron deficiency anemia) is:

FPS Quiz (Beasley) for Facebook

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