رجل عمره ٦٢ سنة عنده تعب منذ شهرين، الهيموغلوبين ٩٫٠، والكريات صغيرة، والفيريتين منخفض. لا يوجد نزيف ظاهر، ونقص وزنه ٥ كجم. ما الخطوة المهمة؟

A 62-year-old man has had fatigue for two months. Hb 9.0 g/dL, small red cells and low ferritin. No visible bleeding, and he has lost 5 kg. What is the important next step?

1. Reassure him it is dietary anaemia
2. Immediate transfusion then discharge
3. Oral iron alone without investigation
4. GI endoscopy to exclude bleeding or a tumour

Answer: D) GI endoscopy to exclude bleeding or a tumour. Iron deficiency in an older man or postmenopausal woman means GI blood loss until proven otherwise, especially with weight loss.