Public Health

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A 50-year-old woman has complained of pain and swelling in her proximal interphalangeal joints, both wrists and knees. She complains of morning stiffness. She has had a hysterectomy 10 yea rs ago. Physical exam shows swelling and thickening of the PIP joints.Hemoglobin is 10.3 g/dL, MCV 80 fl, serum iron 8 μmol/L, ironbinding capacity 40 μmol/L (normal: 45 to 66), saturation 20%. The most likely explanation for this woman’s anemia is
A.Occult blood loss
B.Vitamin deficiency
C.Anemia of chronic disease
D.Sideroblastic anemia