Fe Deficiency

Question 1

best measure of total body iron stores (ref etg)

Answer 1

Ferritin –> is an acute phase reactant
Transferrin saturation levels less than 20% –> indicate an iron supply that is insufficient to support normal erythropoiesis.

(Ref: RACGP Blood Disorders check)

Question 2

Causes of Fe def

Answer 2

Inadequate Intake

Inadequate Absorption
→ Coeliac testing
→ Helicobacter pylori serology screening

Increasing losses
→ GI
→ Menstruation

(Ref: how to treat article)

Question 3

Causes of Fe def

Answer 3

Inadequate Intake

Inadequate Absorption
→ Coeliac testing
→ Helicobacter pylori serology screening

Increasing losses
→ GI
→ Menstruation

(Ref: how to treat article)

Question 4

Aim for oral iron replacement
1/ adults
2/ children

Answer 4

1/ 100-210mg elemental iron
2/ 3-6mg/kg/day to a max of 210mg
(ref: etg)

Question 5

When should oral iorn be taken?
Oral absorption can be reduced by which?
How long to treat?

Answer 5

1/ On an empty stomach, 60mins before food OR 2 hours after food

2/ Calcium supplements
PPI's 
H2-receptor antagonists
Antacids
Tea 
(Ref: how to treat article) 

3/Oral iron supplementation should continue for 3-6 months after the normalisation of the serum ferritin in adults, and for 2-3 months after the normalisation of the serum ferritin in children.

(RACGP Blood Disorders

Question 6

Indications for parental iron?

Answer 6

Failure of oral therapies 
Proximal Small Bowel Resection 
CKD
Persistent mentraul blood loss or GI blood that cannot be compensated with oral therapy 
(ref: how to treat article quiz) 

(Ref: how to treat article)

Question 7

Which herbal medications have an effect on homeostasis?

Answer 7

Complementary medicines including glucosamine, fish oil products, garlic, ginko biloba and ginseng may have effects on haemostasis.

(Ref: Blood Disorders Check 2016)