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: Pediatrics
First change of improvement noted after iron therapy is initiated - 
Select and explain. 
A. Decreased irritability, B. Reticulcytosis, C. Increase in serum iron levels, D. Replenishment of iron stores
A: Decreased irritability
Answer: A: Decreased irritability 
Explanation: Ans is 'a' i.e., Decreased irritability"When specific iron therapy is given, patients often show rapid subjective improvment, with disappearance or marked diminution offatigue, lassitude, and other nonspecificc symptoms (e.g. irritability). This response may occur before any improvement in anemia observed" Wintrobe'so The earliest hematological evidence of response of treatment is an increase in the percentage of reticulocytes and their hemoglobin content.o So, Overall earliest indicator of improvement decreased fatigue, lassitude and other nonspecific symptoms Earliest hematological evidence of improvement ---> Increased reticulocyte count.