A patient with moderate anemia has an elevated MCV and hypersegmented neutrophils. Which of the following should be ordered first?

Question

Quizplus · Accepted Answer

Elevated MCV and hypersegmented neutrophils are typical of megaloblastic anemia, which is most commonly caused by deficiencies in Vitamin B12 and folate. Therefore, Vitamin B12 and folate assays are the most appropriate initial tests to order. The Schilling test, gastric analysis, and antibodies to IF may be ordered if Vitamin B12 deficiency is confirmed, but they are not the first-line diagnostic tests.

A Patient with Moderate Anemia Has an Elevated MCV and Hypersegmented