This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
[{'content': 'A 60 yr old female with history 8 blood transfusions in 2yrs. Her Hb-60g/L, TLC-5800, platelet- 3.4 lakhs, MCV-60, RBC-2.1 lakhs/mm3. She is having hypochromic microcytic anemia. Which investigation is not needed? \nSelect and explain. \nA. Evaluation for pulmonary hemosisderosis, B. Urinary hemosiderin, C. Bone marrow examination, D. GI endoscopy', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Ans. is \'a\' i.e.,Evaluation of pulmonary hemosiderosis Anemia with low RBC count, microcytosis and hypochromia point towards iron deficiency anemia. o Bone marrow examination is indicated :- "Bone marrow biopsy" in iron deficiency anemia demonstrates erythroid hyperplasia and micronormoblasts reaction. Prussian blue staining of the bone marrow aspirate and smear and biopsy demonstrates absence of iron stores. o The patient continues to have iron deficiency anemia despite the blood transfusions. GI endoscopy may be indicated to rule out GIT pathology as chronic blood loss may result from GIT ( malena, hematemesis). Urine examination may be indicated to see hemosiderin in urine because chronic blood loss may also result from hemolytic anemia ( eg Paroxysmal nocturnal hemoglobinuria).', 'role': 'assistant'}]