Internal Medicine

Q: A 70-year-old woman has been in long-standing poor health, with severe diabetes mellitus and rheumatoid arthritis. Her physician notes that she appears pale and orders a hematocrit, which shows a result of 35%. Examination of the blood smear reveals a microcytic anemia. The physician is considering a differential diagnosis of iron deficiency anemia versus anemia of chronic disease. Which of the following laboratory determinations would be most helpful in distinguishing these conditions?

(a) :  Erythrocyte:granulocyte ratio in bone marrow
(b) :  Presence or absence of polychromatophilic target cells
(c) :  Presence or absence of stippled erythrocytes
(d) :  Serum ferritin
(e) :  Serum iron
Answer:  Serum ferritin

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