Long-standing Hypertension in Medicine / Internal Medicine — 70yo Woman | Nephrology | SMLE Q#11522
SMLE Question #11522
Medicine / Internal Medicine
Nephrology
Objective: OBJ-188
Last updated: February 2026
A 70-year-old woman with long-standing hypertension and stage 4 chronic kidney disease reports 5 months of progressive fatigue and exertional dyspnea. She has pallor with no hepatosplenomegaly or lymphadenopathy. CBC shows hemoglobin 89 g/L, MCV 90 fL, and a low reticulocyte count. Iron studies show ferritin 130 µg/L, serum iron 11.6 µmol/L, and TIBC 50 µmol/L. Peripheral smear shows normocytic, normochromic red blood cells without dysplasia. What is the most likely cause of her anemia?
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