Very easy and V practical Q - dolly123

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A 68-year-old man presents to hospital with complaints of worsening fatigue for the past few weeks. Two months ago, his nephrologist started him on erythropoietin after dialysis. He has been on hemodialysis for the past 19 years because his type II diabetes was never controlled. He denies chest pain or dizziness but reports feeling "awfully winded after I walk for one block." He also denies melena, hematochezia, or other bleeding. His medications include insulin, phosphate binders, and amlodipine. On physical examination, he appears pale and tired. His temperature is 98.9 F, and respirations are 18/min. When seated, his blood pressure is 140/72 mm Hg, and his pulse is 96/min. When standing, his blood pressure becomes 148/80, and pulse becomes 98/min. Heart and lung sounds are normal, and his abdomen is benign. Rectal examination reveals a trace guaiac-positive stool. Laboratory studies show:

CBC: WBC 8,000/mm3; hemoglobin 9.5 mg/dL; hematocrit 31%; platelets 320,000/mm3.
MCV 72 FL (normal 82-98 FL); MCHC 30 g/dL (normal 32-36 g/dL); RDW 17% (normal 13-15 %)
Reticulocyte count (corrected) 1%
Serum iron: decreased
Ferritin 12 ng/mL (normal 15-200 ng/mL); TIBC elevated
Bilirubin 0.4 mg/dL; direct bilirubin 0.2 mg/dL
EKG: no new ST-T wave abnormalities, no Q waves
Chest x-ray: borderline cardiomegaly

What is the next best step in the management of this patient?

(A) Ferrous sulfate
(B) Blood transfusion
© Colonoscopy
(D) Increase the erythropoietin dose
(E) Bone marrow biopsy