A 52-year-old man with chronic gastrointestinal blood loss presents with microcytic anemia. Regarding the stages and diagnostic criteria of iron deficiency, all of the following are correct EXCEPT:
A. Stage 2 (iron-deficient erythropoiesis) shows low ferritin, elevated sTfR, and elevated free erythrocyte protoporphyrin (FEP), but hemoglobin remains normal
B. Elevated serum iron and elevated transferrin saturation indicate iron deficiency and warrant urgent iron supplementation
C. Stage 1 (iron depletion) is characterized by low serum ferritin and normal hemoglobin; bone marrow iron stores are absent
D. Stage 3 (iron deficiency anemia) presents with microcytic hypochromic anemia, low ferritin, elevated sTfR, and elevated FEP
Explanation
Stages of Iron Deficiency and Diagnostic Criteria
Correct Answer Explanation
Key Point
Elevated serum iron and elevated transferrin saturation are OPPOSITE of iron deficiency findings. These findings indicate iron overload (hemochromatosis, secondary hemosiderosis), not iron deficiency.
High-YieldNEET PG
In iron deficiency:
Serum iron is DECREASED
Transferrin saturation is DECREASED (<16%)
TIBC is INCREASED
This option contains a fundamental contradiction to the diagnosis and would be contraindicated for iron supplementation.
Do NOT confuse iron deficiency with iron overload. Elevated iron and saturation suggest hemochromatosis or secondary hemosiderosis—conditions requiring iron restriction, not supplementation. Always check ferritin and transferrin saturation together to interpret iron status correctly.
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