A 17-year-old girl comes to the office for a follow-up visit after being diagnosed with iron deficiency anemia. She has been patient of yours since birth and has always been very healthy. At the last visit, which was 6 weeks ago, she complained of fatigue and she had pale skin and mucus membranes. She is sexually active with one partner and they use condoms for contraception. Initial laboratory studies showed:
Hemoglobin 9.5 g/dL
Hematocrit 30%
Ferritin 5 ng/ml
You advised her to begin taking ferrous sulfate and to eat a well balanced, iron-containing diet with meat. The results of her laboratory studies today show that she is responding to therapy. The most appropriate next step is to
A. advise her to consider oral contraceptive pills to decrease her menstrual blood loss
B. check the mean corpuscular hemoglobin (MCV) and red cell distribution width (RDW)
C. discontinue the ferrous sulfate, but tell her to continue to eat a well-balanced, iron containing diet
D. do a colonoscopy to check for a source of blood loss
E. make no changes in her current treatment plan
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