For a female patient with microcytic hypochromic anemia and a family history of Italian ancestry, which lab test should be ordered first based on the most common cause?

In the context of a female patient presenting with microcytic hypochromic anemia, the first lab test to order should focus on iron deficiency, which is the most common cause of this type of anemia, especially in populations with higher rates of iron deficiency due to dietary habits or common physiological conditions, such as menstruation.

Ordering TIBC (Total Iron-Binding Capacity) and Ferritin levels is particularly relevant as they are crucial for assessing a patient’s iron status. Ferritin reflects the stored iron in the body, while TIBC provides information about the transport capacity for iron. In cases of iron deficiency anemia, you would typically see a low ferritin level along with a high TIBC.

Given the patient's family history of Italian ancestry, it is important to consider the cultural and dietary factors that could contribute to iron status. Additionally, while beta-thalassemia, which is more common in populations of Mediterranean descent, can cause microcytic anemia, the most immediate concern in this scenario is to rule out iron deficiency before considering other types of anemia.

Thus, starting with TIBC and Ferritin allows for an efficient and effective evaluation of the most likely cause of the microcytic hypochromic anemia in this patient before further investigations into