IRON DEFICIENCY ANAEMIA Flashcards Preview

HAEMATOLOGY > IRON DEFICIENCY ANAEMIA > Flashcards

Flashcards in IRON DEFICIENCY ANAEMIA Deck (23):
1

How would you describe the blood film of someone with iron deficiency anaemia?

Microcytic
Hypochromic

2

Where is iron absorbed in the intestine?

Duodenum
Upper jejunum
Acidic conditions help absorption of iron (ferrous form)

3

What is the daily requirement of iron for a male adult?

1 mg

4

What is the daily requirement of iron for a female adult of reproductive age?

2-3 mg

5

What is the daily requirement of iron for a pregnant lady?

3-4 mg

6

What carries iron in the blood?

Transferrin

7

In what forms is iron stored in?

Ferritin
Haemosiderin (found mainly in macrophages)

8

What are the initial clinical features of iron deficiency anaemia?

Tiredness/lethargy
Often no symptoms

9

What are the more serious clinical features of iron deficiency anaemia?

Dyspnoea
Headaches
Tinitus
Taste disturbance

10

What are the risk factors for development of iron deficiency?

Age - infants (with history of prematurity), adolescents, postmenopausal women, elderly

Bleeding

Malabsorption - coeliac, atrophic gastritis

Sex - female

Reproduction - menorrhagia

Drug history - especially aspirin and other NSAIDs

Diet - vegetarians

Pregnancy and breast feeding

Infection - worldwide biggest cause of iron deficiency is hookworm

11

On examination, what might you notice in someone with iron deficiency anaemia?

Koilonychia
Angular stomatitis
Glossitis
Atrophy of the skin
Low blood pressure - especially from sitting to standing
Tachycardia

12

What are the investigations that you would order for someone with suspected iron deficiency anaemia?

Full blood count
Blood film
Serum iron/ferritin
Total iron binding capacity

13

When might the blood film of someone with iron deficiency anaemia be normocytic?

When in conjunction with folate deficiency or other malabsorption.

14

When might serum ferritin be raised despite the patient having an iron deficiency anaemia?

It is an acute phase protein so can be raised in conjunction with other active disease such as:
Rheumatoid disease
Liver disease - ferritin stored in hepatocytes so damage will cause release
Malignancy

15

In cases of iron deficiency where the ferritin level is likely to be misleading, what might be used to help diagnosis?

Soluble transferrin receptor - receptors on the surface of red blood cells that are increased in iron deficiency

16

How would you manage someone with iron deficiency anaemia?

Look for cause
Iron replacement therapy

17

In a male or postmenopausal women with iron deficiency anaemia with no obviously apparent cause what test must you order to rule something out?

Endoscopy to rule out gastrointestinal bleed

18

What form is iron given in orally?

Ferrous salts - ferrous sulphate, ferrous gluconate or ferrous fumarate

19

What are the side effects of ferrous salts, used as iron replacement therapy?

Nausea
Constipation
Diarrhoea

20

Once haemoglobin concentration is back to normal in someone treated for iron defiency anaemia, should they stop their iron supplements?

Not immediately, they should continue for 3 months before stopping. This is to replenish iron stores.

21

If a patient is not tolerating oral iron replacement therapy or their daily losses outweigh the total absorption capacity, what therapies might be used to treat someones iron deficiency anaemia?

IV iron preparations including iron hydroxide sucrose.

22

Under what conditions must IV iron replacement therapy be given and why?

Under strict medical supervision
Risk of anaphylaxis

23

When is blood transfusion indicated as a treatment option for iron deficiency anaemia?

Only if the patient is decompensated.