IRON DEFICIENCY ANAEMIA Flashcards Preview

HAEMATOLOGY > IRON DEFICIENCY ANAEMIA > Flashcards

Flashcards in IRON DEFICIENCY ANAEMIA Deck (23)
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1
Q

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

A

Microcytic

Hypochromic

2
Q

Where is iron absorbed in the intestine?

A

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

3
Q

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

A

1 mg

4
Q

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

A

2-3 mg

5
Q

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

A

3-4 mg

6
Q

What carries iron in the blood?

A

Transferrin

7
Q

In what forms is iron stored in?

A

Ferritin

Haemosiderin (found mainly in macrophages)

8
Q

What are the initial clinical features of iron deficiency anaemia?

A

Tiredness/lethargy

Often no symptoms

9
Q

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

A

Dyspnoea
Headaches
Tinitus
Taste disturbance

10
Q

What are the risk factors for development of iron deficiency?

A

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
Q

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

A
Koilonychia
Angular stomatitis
Glossitis
Atrophy of the skin
Low blood pressure - especially from sitting to standing
Tachycardia
12
Q

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

A

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

13
Q

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

A

When in conjunction with folate deficiency or other malabsorption.

14
Q

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

A

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
Q

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

A

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

16
Q

How would you manage someone with iron deficiency anaemia?

A

Look for cause

Iron replacement therapy

17
Q

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

A

Endoscopy to rule out gastrointestinal bleed

18
Q

What form is iron given in orally?

A

Ferrous salts - ferrous sulphate, ferrous gluconate or ferrous fumarate

19
Q

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

A

Nausea
Constipation
Diarrhoea

20
Q

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

A

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

21
Q

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?

A

IV iron preparations including iron hydroxide sucrose.

22
Q

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

A

Under strict medical supervision

Risk of anaphylaxis

23
Q

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

A

Only if the patient is decompensated.