Anaemia: practice question

A Pathology 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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Pathology · Anaemia

Sample item

A young woman with heavy menstrual bleeding has fatigue and a microcytic hypochromic blood picture. Which iron profile fits the most likely diagnosis?

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

The answer and the reasoning

B. Low serum iron, high total iron binding capacity, low ferritin

In iron deficiency, stores are exhausted so ferritin is low, serum iron is low and transferrin synthesis rises, increasing the total iron binding capacity. Anaemia of chronic disease shows low iron with low capacity and normal or high ferritin because hepcidin traps iron in stores.

Option by option

  • A. Normal serum iron, normal total iron binding capacity, normal ferritin

    A fully normal profile would be seen in a trait such as thalassaemia minor and does not fit established iron deficiency.

  • B. Low serum iron, high total iron binding capacity, low ferritin (correct)

    Correct. Depleted stores give low ferritin and low iron, with compensatory rise of binding capacity.

  • C. High serum iron, low total iron binding capacity, high ferritin

    This pattern of high iron with high ferritin reflects iron overload such as haemochromatosis, not deficiency.

  • D. Low serum iron, low total iron binding capacity, high ferritin

    This pattern, with raised ferritin, is typical of anaemia of chronic disease driven by hepcidin.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Low serum iron, high total iron binding capacity, low ferritin. In iron deficiency, stores are exhausted so ferritin is low, serum iron is low and transferrin synthesis rises, increasing the total iron binding capacity.

Why is "Normal serum iron, normal total iron binding capacity, normal ferritin" not the answer?

A fully normal profile would be seen in a trait such as thalassaemia minor and does not fit established iron deficiency.

Why is "High serum iron, low total iron binding capacity, high ferritin" not the answer?

This pattern of high iron with high ferritin reflects iron overload such as haemochromatosis, not deficiency.

Why is "Low serum iron, low total iron binding capacity, high ferritin" not the answer?

This pattern, with raised ferritin, is typical of anaemia of chronic disease driven by hepcidin.

What concept does this question test?

It tests Anaemia in Pathology. Anaemia of chronic disease shows low iron with low capacity and normal or high ferritin because hepcidin traps iron in stores.

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 Anaemia?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.