A 60-year-old male presents for an office evaluation, complaining of fatigue for 6 months. He reports a 30-pound weight loss over the past year, which his wife attributes to the fact that he is constantly chewing on ice and does not have time to eat solid food. He has a past medical history of diabetes and COPD and a remote history of tobacco and alcohol use (he quit both 20 years ago). His current medications include metformin and albuterol. His review of systems is otherwise negative. His physical exam reveals a well-appearing male with normal vital signs. You perform a complete exam, including a rectal exam, and find no abnormalities. A CBC is performed, which demonstrates a WBC 6,000/mm3, hemoglobin 11.8 g/dl, hematocrit 35%, platelets 280,000/mm3, MCV 74 fl.

1		What is your next step in his evaluation and why?
			A)	Consider addition of oral iron supplementation to his usual medications, as he likely has a dietary iron deficiency.
			B)	Schedule him for a follow-up appointment in 6 months, as he is generally healthy for a 60-year-old.
			C)	Evaluate him for thalassemia, because he has a low MCV and no evidence of bleeding.
			D)	Schedule him for a colonoscopy, as he has microcytic anemia and pica, and you are worried about malignancy.
			E)	Evaluate his B12 and folate stores, as he has a history of using alcohol.