Q1: Iron deficiency anemia is best diagnosed by?
A) increased TIBC
B) Serum ferritin
Q2: Iron deficiency anemia is best diagnosed by?
A) increased tibc
B) Serum ferritin
C) Bone Marrow Biposy
Answer 1: A
Answer 2: C
Explanation: I know, I know, You'll say why not B for Question 1? and you may give "Goljan" Reference.
Read carefully the options. In option A we have Increased TBIC & in option B we have "just" Serum Ferritin (Low or High? we have No idea)
Remember that Ferritin is acute phase reactant and can be INcreased in ANY Infectious process. (Just for Info in Adult onset Still's disease we will have High Ferritin - 3 times to NORMAL level)
LOW Ferritin is HIGHLY Specific for iron deficiency anemia.
Also keep in mind "ONLY microcytic anemia with HIGH Total iron Binding Capicity (TIBC) is Fe deficiency anemia."
Now for Question 1 Selecting simple option B (S. Ferritin) will be WRONG. Correct answer will be Increased TIBC.
The Most Accurate Test for Iron deficiency anemia is "Bone Marrow Biopsy".
Just for practice One more question:
Q1: Iron deficiency anemia is best diagnosed by?
A) increased TIBC
B) Low Serum ferritin
Answer: B
