2. Iron deficiency anemia

Question 1

pathophysiology of iron deficiency anemia

Answer 1

depleted bone marrow iron and body iron stores–> decreased heme synthesis–> microcytosis–> anemia (microcytic, hypochromic)

Question 2

what are the 3 stages of iron deficiency anemia ?

Answer 2

1. negative iron balance (seen with a decrease in ferritin)
2. iron-deficient erythropoiesis- low ferritin and serum iron, increase TIBC. once transferrin saturation falls to 15%–> hemoglobin synthesis becomes impaired
3. iron deficiency anemia- Hgb and Ht fall

Question 3

Etiology of IDA

Answer 3

1. increased demand of iron- pregnancy
2. increase iron loss- GI bleeding, mensuration
3. decreased iron intake- dietary, malabsorption (celiac,crohn)

Question 4

specific manifestation of IDA

Answer 4

Angular cheilosis
Atrophic glossitis 
Pica
Koilonychia 
**Plummer-Vinson syndrome

Question 5

what is Mentzer index?

Answer 5

MCV/RBC

used to differentiate IDA from beta-thalassemia
<13–> thalassemia (RBC count is not affected, cells are just smaller)
>13–> IDA

Question 6

Why does platelet count increase in IDA?

Answer 6

reactive thrombocytosis

Question 7

management of IDA

Answer 7

1. oral iron (Ferrous-gluconate, Ferrous-fumarate, PIC) - 6 weeks to correct anemia
2. IV iron (Ferrous-sulfate, iron-sucrose, PIC)- commonly for dialysis or cancer patients prior to EPO treatment
3. transfusion therapy