3 Months Of Progressive in Medicine / Internal Medicine — 23yo Woman | Hematology | SMLE Q#17159
SMLE Question #17159
Medicine / Internal Medicine
Hematology
Objective: OBJ-101
Last updated: February 2026
A 23-year-old woman presents with 3 months of progressive fatigue, reduced exercise tolerance, and cravings to chew ice and chalk. Over the past year, her menstrual periods have become heavier and longer. She follows a predominantly vegetarian diet with limited red meat. She denies melena, hematochezia, chronic diarrhea, weight loss, or chronic illness. Examination shows conjunctival pallor and brittle, spoon-shaped nails; there is no jaundice or hepatosplenomegaly. Complete blood count and blood film are shown below. What is the most likely diagnosis?
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