Minerals: iron deficiency indices: practice question

A Biochemistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Biochemistry · Minerals: iron deficiency indices

Sample item

A 14-year-old vegetarian girl with heavy menstrual periods has pallor and koilonychia. Hb is 8 g/dL, MCV 68 fL and RDW is raised. Which laboratory change best reflects depleted iron stores?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Low serum ferritin

Ferritin reflects storage iron and falls first in absolute iron deficiency. Transferrin and total iron-binding capacity rise as the liver synthesises more transferrin, transferrin saturation falls, and hepcidin is suppressed to increase absorption.

Option by option

  • A. Low serum ferritin (correct)

    Low ferritin indicates exhausted iron stores in the absence of inflammation.

  • B. Raised serum hepcidin

    Hepcidin is suppressed in iron deficiency to maximise intestinal absorption.

  • C. Reduced total iron-binding capacity

    Total iron-binding capacity rises, not falls, in iron deficiency.

  • D. Raised transferrin saturation

    Transferrin saturation falls because serum iron is low while binding capacity is high.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Biochemistry question

What is the answer to this Biochemistry question?

The best answer is A, Low serum ferritin. Ferritin reflects storage iron and falls first in absolute iron deficiency.

Why is "Raised serum hepcidin" not the answer?

Hepcidin is suppressed in iron deficiency to maximise intestinal absorption.

Why is "Reduced total iron-binding capacity" not the answer?

Total iron-binding capacity rises, not falls, in iron deficiency.

Why is "Raised transferrin saturation" not the answer?

Transferrin saturation falls because serum iron is low while binding capacity is high.

What concept does this question test?

It tests Minerals: iron deficiency indices in Biochemistry. Transferrin and total iron-binding capacity rise as the liver synthesises more transferrin, transferrin saturation falls, and hepcidin is suppressed to increase absorption.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Minerals: iron deficiency indices?

Build one table of enzyme deficiency, disease, inheritance and key finding, then revise it by spaced recall. Then use the flashcards and the other Biochemistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.