What might the hematologic findings indicate and what should be done to further evaluate them?

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What might the hematologic findings indicate and what should be done to further evaluate them?

WBC = normal with a normal differential and platelet count  Hct = 29%; MCV = normal, MCHC = slightly decreased; RDW = markedly increased; reticulocyte count < 2%  Smear with mixed microcytic/hypochromic and macrocytic/normochromic red blood cells; WBC and platelets appear normal  PT/PTT, liver function tests, electrolytes, and amylase normal  Upper endoscopy with 2 cm. duodenal ulcer with evidence of recent but no acute hemorrhage  ADDITIONAL LABORATORY RESULTS:  Serum iron, total iron binding capacity, saturation, and ferritin all reduced  Bone marrow biopsy with megaloblastic changes and low iron stores  Serum folate and red blood cell folate low; B12 normal

What might the hematologic findings indicate and what should be done to further evaluate them?

 

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