A 32-year-old patient arrives at the emergency department with fatigue, dyspnea, and skin pallor. Laboratory results show hemoglobin of 7 g/dL, mean corpuscular volume (MCV) of 72 fL, and serum iron of 20 μg/dL. The patient has a past medical history of menorrhagia. Which of the following is the MOST appropriate initial treatment?
The patient's clinical presentation and laboratory findings are indicative of iron deficiency anemia, which is commonly associated with chronic blood loss such as that from menorrhagia. The low serum iron and low MCV (microcytic anemia) confirm this diagnosis. The most appropriate initial treatment is iron supplementation, either orally or intravenously, depending on the severity of the symptoms and patient's ability to tolerate oral medications. Blood transfusion is reserved for symptomatic anemia with hemodynamic instability or when rapid replenishment is necessary, not as an initial standard treatment in stable patients. Vitamin B12 and folate supplementation are used to treat macrocytic anemias, which are not indicated by this patient's low MCV.
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