The correct answer here is b. The patient is likely to have noticed increasing dyspnea over a period of time. The commonest cause of microcytic hypochromic anemia is Iron deficiency and this us most usually associated with females during the reproductive period of life. In a 60 year old male whe have to look for a cause of long term bleeding. The most important causes relate to the GIT, - benign and malignant ulcers.
Hematuria is unlikely to lead to sufficient loss of blood to cause an iron deficiency anemia before something is done to rectify the matter
Hypertension is a sign - not a symptom and there is no particular mechanism whereby it could lead to loss of Iron from the system
Chronic cough likewise is unrelated to iron loss
Constipation per se is not associated with loss of iron but if related to Carcinoma of the colon then bleeding may lead to anemia. However, this would be more usual with right sided tumors which can grow larger because they do not cause constipation. Left sided tumors may present with constipation before they have had time to lead to sufficient blood loss to cause anemia.
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