Anaemia - Microcytic and Macrocytic

Question 1

Describe the clinical features of iron deficiency anaemia. (4)

Answer 1

Koilonychia
Atrophic (painless) glossitis
Angular stomatitis
Oesophageal web (Plummer Vinson syndrome)

Question 2

Describe the features seen on a peripheral blood film in iron deficiency anaemia. (4)

Answer 2

Microcytic, hypochromic RBCs
Low transferrin saturation (<15%)
Normal transferrin levels
Low serum ferritin

Question 3

What investigations would you do for IDA?

Answer 3

Bloods:

• FBC
• Haematinics
• Transferrin saturation
• Transferrin levels
• Serum ferritin

Peripheral blood film

Question 4

List 3 causes of IDA.

Answer 4

Blood loss (e.g. periods/GI bleed)
Poor diet
Malabsorption (e.g. Coeliac)

Question 5

Describe the features seen on a peripheral blood film in anaemia of chronic disease (ACD). (8)

Answer 5

Normal OR microcytic RBCs
Normal OR decreased MCV
Increased ESR
RBC rouleaux
Normal OR increased ferritin
Decreased iron levels
Decreased total iron binding capacity
Decreased transferrin levels

Question 6

Describe the clinical features of anaemia due to B12/folate deficiency. (6)

Answer 6

Fatigue
Easy bruising
Painful atrophic glossitis
Jaundice
Bilateral peripheral neuropathy
Demyelination of pyramidal tracts

Question 7

Describe the features seen on a peripheral blood film in anaemia due to B12/folate deficiency. (5)

Answer 7

Megaloblastic anaemia
Leukopenia
Thrombocytopenia
Elevated unconjugated bilirubin
Elevated LDH