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Question

A 26-year-old female complains of severe fatigue and myalgia. Examination reveals pallor and mild splenomegaly. Haematological investigations are shown below:

Haemoglobin - 10 g/dL

Peripheral smear - Microcytic hypochromic picture with anisocytosis

Reticulocyte count - 5%

Serum ferritin - 300 microgram/L

What is the most likely underlying diagnosis?

This question was previously asked in
UPSC CMS 2026 Surgery, Gynaecology & Obstetrics, and PSM Question Paper (02-Aug-2026)
The correct answer is

β-Thalassemia

Microcytic hypochromic anemia with a normal/high serum ferritin (excluding iron deficiency) plus splenomegaly and an elevated reticulocyte count (indicating a compensated haemolytic process) points to β-thalassemia (trait/intermedia) rather than iron deficiency, which would show low ferritin and low reticulocyte count.

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Important Questions from Anemia

  1. Macrocytosis is seen in all of the following conditions EXCEPT:
  2. All of the following cause microcytic hypochromic anemia EXCEPT:
  3. Pyruvate kinase deficiency results in deficiency of ATP production and a chronic haemolytic anaemia. The disorder is inherited as an:
  4. Sickle cell disease may be associated with any of the following EXCEPT:
  5. Every individual carries four alpha gene alleles. Deletion of three alleles leads to development of:
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