F - Hematological disorders - Anemia: Iron-deficiency Wk8

Question 1

Whats Iron deficiency anemia?

Answer 1

1. decreased iron stores in the body
   which are essential for production of hemoglobin in RBCs

Question 2

What are the causes & Risk factors of iron deficiency anemia?

Answer 2

1. decreased dietary intake
   - decreased intake of iron-rich foods
   - like red meat, beans, and leafy greens

Risk factors:
- poor nutritional status from strict diets
- chronic alcohol use
- homelessness, abuse or neglect

2. decreased GI absorption
   - due to decreased stomach acid production
3. increased body demand for iron
   - in children due to rapid growth
   - during pregnancy and lactation
4. increased iron loss
   - acute hemorrhage / chronic slow bleeding
   - increased destruction of RBCs

Risk factors:
- trauma, frequent or heavy menstruation
- bleeding gastric ulcers
- colorectal cancer
- increased autoimmune hemolytic anaemia
- adverse drug reactions
increased destruction by the spleen

Question 3

Whats the pathology of iron deficiency anemia?

Answer 3

1. Insufficient iron stores needed to sustain normal hemoglobin production -> not enough hemoglobin to fill a normal-sized RBC
2. bone marrow starts producing smaller cells that contain less hemoglobin to try to sustain erythropoiesis

3 appear paler under the microscope = hypochromic

4. may develop poikilocytes
   - abnormally shaped RBCs that appear flat, elongated, or teardrop -shaped
5. may develop anisocytosis = unequally sized RBCs

Question 4

What are the clinical manifestations of iron deficiency anemia?

Answer 4

1. pallor, weakness, fatigue, reduced exercise tolerance
2. headaches, dizziness, tachycardia.

severe cases:
- decreased oxygen saturation, chest pain
- irregular heartbeat, systolic heart murmur

3. sore & glossy tongue with glossitis / swollen tongue
   - lack of o2 to tongue tissues worsens inflammation
4. angular cheilitis
   - fissures around the corners of the mouth
   - Iron deficiency weakens skin barrier -> corners of the mouth more prone to cracking & infections
5. koilonychia
   - brittle, spoon-shaped nails
   - Iron is crucial for keratin production
6. pica
   - crave & eat non-food substances, such as clay or dirt
   - body craves non-food substances (like clay, chalk, or ice) as a way to compensate for nutritional deficiencies

Question 5

Treatment of iron deficiency anemia?

Answer 5

1. increase dietary intake of iron + oral supplements
2. can’t tolerate oral iron supplements -> give IV iron
3. severe cases may need transfusions