American Board of Internal Medicine (ABIM) Certification Practice Exam

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Current guidelines for treating restless legs syndrome recommend supplementation with ferrous sulfate and vitamin C when serum ferritin is below what level?

50 ng/mL
75 ng/mL
100 ng/mL
125 ng/mL

The correct answer is: 75 ng/mL

When considering the treatment for restless legs syndrome (RLS), current guidelines highlight the importance of addressing iron deficiency, particularly when serum ferritin levels are low. Supplementation with ferrous sulfate can be an effective intervention when serum ferritin falls below a specific threshold. The guideline recommendation indicates that when serum ferritin is below 75 ng/mL, it is advisable to initiate supplementation with ferrous sulfate along with vitamin C to enhance the absorption of iron. This threshold is based on research indicating that ferritin levels below this point are associated with an increased risk of RLS symptoms and that restoring iron levels can alleviate these symptoms. Maintaining ferritin levels above this threshold is essential as it can contribute positively to the management of RLS and improve patient outcomes. Therefore, it is important to monitor ferritin levels in patients with RLS and consider supplementation if levels are below 75 ng/mL, as this reflects the most current clinical understanding in managing iron deficiency in the context of this syndrome.