Iron deficiency anemia typically presents with which red blood cell morphology?

• A. Macrocytic anemia
• B. Normocytic anemia
• C. Hypochromic microcytic anemia
• D. Microcytic anemia

Answer: (C)

Iron deficiency impairs hemoglobin synthesis, so red blood cells that are produced are smaller and contain less hemoglobin. This creates the classic hypochromic, microcytic pattern: small cells (microcytosis) with pale color due to low hemoglobin (hypochromia). On a smear you’d see increased central pallor and an overall decreased MCV, often with low MCHC. Early iron deficiency can be normocytic, but as it progresses the microcytic, hypochromic appearance becomes predominant. This differs from macrocytic anemia (larger cells from B12/folate deficiency) and from normocytic causes like acute blood loss or anemia of chronic disease.