250 NBME-style questions with deep clinical explanations. AI-generated. Human-verified. Everything you need to ace Step 1.
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Full clinical scenarios with demographics, exam findings, labs, and five plausible choices — built on the real exam format.
Every answer teaches the mechanism, not just the correct letter. Includes a one-line clinical takeaway you can actually remember.
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A 62-year-old man presents with progressive fatigue and exertional dyspnea over 4 months. He reports dark, tarry stools on two occasions. On exam he is pale with tachycardia. CBC shows hemoglobin 8.4 g/dL, MCV 71 fL. Serum iron is low, TIBC is elevated, and ferritin is 6 ng/mL. Peripheral smear reveals microcytic, hypochromic red cells with occasional target cells.
Which of the following best describes the underlying cause of this anemia?
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