Anaemia - Treatment

Question 1

How would you treat IDA? (2)

Answer 1

Investigation of underlying cause

Iron replacement, e.g.

• Ferrous sulphate
• Ferrous gluconate
• IV iron (rare)

Question 2

When would you give IV iron instead of oral in IDA? (3)

Answer 2

Intolerance of oral iron (rare)
Non-compliance
Renal anaemia with concurrent EPO replacement

Question 3

How would you treat anaemia of chronic disease? (1)

Answer 3

Treat underlying disorder

Question 4

How would you treat anaemia caused by B12/folate deficiency? (3)

Answer 4

Treat underlying cause
B12 supplements
Folic acid supplements

Question 5

How would you treat thalassaemia? (2)

Answer 5

Blood transfusions

Splenectomy

Question 6

How would you treat sickle cell anaemia? (3)

Answer 6

Prevention of vaso-occlusive crises
Management of crises
Bone marrow transplant

Question 7

How would you prevent vaso-occlusive crises in sickle cell anaemia? (4)

Answer 7

Hydration
Analgesia
Folic acid supplements
Prophylactic vaccination, esp.
-Pneumococcus
-Meningococcus
-Haemophilus

Question 8

How would you treat an acute sickle cell crisis? (6)

Answer 8

Oxygen
Fluids
Analgesia
Antibiotics
Transfusion or red cell exchange
Specialist care

Question 9

How would you treat hereditary spherocytosis? (3)

Answer 9

Splenectomy
Folic acid supplements
Prophylaxis, e.g. vaccines for:
-Pneumococcus
-Meningococcus
-Haemophilus

Question 10

How would you treat warm AIHA? (5)

Answer 10

Stop causative drugs
Steroids (oral prednisolone)
Immunosuppression
Splenectomy
Rituximab (anti-CD20)

Question 11

How would you treat cold AIHA? (1)

Answer 11

Advise patients to keep warm