[GP] Microcytic Anaemia Flashcards
what is the most common form of microcytic anaemia in the UK?
iron deficiency anaemia (IDA)
what is an important red flag sx in both males and post-menopausal women ≥60 for colorectal cancer?
iron deficiency anaemia (IDA)
pt ≥40-49 with IDA + unexplained wt loss, abdo pain and rectal bleeding. mx?
2WW (week wait) colonoscopy
pt ≥50-59 with IDA + rectal bleeding. mx?
2WW colonoscopy
pt ≥50-59 with IDA, no rectal bleeding. mx?
FOB test
pt ≥60 with IDA. mx?
2WW colonoscopy
IDA can also be a feature of upper GI malignancies. what should IDA be investigated with if there is dyspepsia present?
2WW upper GI endoscopy
what are the ALARMS sx for dyspepsia?
A - anaemia L - loss of wt A - anorexia R - recent onset M - malaena/mass S - swallowing difficulties
what if a pt has dyspepsia but no IDA. mx?
only pts >55 years old should undergo urgent endoscopy
what can anaemia be classified into?
- microcytic
- normocytic
- macrocytic
what are the causes of microcytic anaemia?
- IDA
- thalassaemia
- sideroblastic anaemia
what are the causes of normocytic anaemia?
- anaemia of chronic disease
- CKD (EPO-related)
- haematological malignancies
- haemolytic anaemia
- mixed microcytic + macrocytic
what can macrocytic anaemia be divided into?
- megaloblastic
- non-megaloblastic
what are the causes of megaloblastic macrocytic anaemia?
- B12 deficiency
- folate deficiency
- pernicious anaemia
what are the causes of non-megaloblastic macrocytic anaemia?
- alcohol excess
- hypothyroidism
- reticulocytosis
- liver disease
*serum ferritin: reduced
*serum TIBC: increased
*transferrin saturation: low
iron in marrow: absent
iron in erythroblasts: absent
MCV: low
dx?
IDA
serum ferritin: normal serum TIBC: normal transferrin saturation: normal iron in marrow: present iron in erythroblasts: present *MCV: very low
dx?
thalassaemia
serum ferritin: raised serum TIBC: decreased transferrin saturation: high-normal iron in marrow: +++ *iron in erythroblasts: ring-forms MCV: low (inherited)
dx?
sideroblastic anaemia
*serum ferritin: raised serum TIBC: low-normal transferrin saturation: low iron in marrow: present iron in erythroblasts: absent *MCV: low-normal
dx?
anaemia of chronic disease
microcytic anaemia, disproportionately low MCV. dx?
thalassaemia
normocytic anaemia, reduced renal function. dx?
CKD-related anaemia (EPO)
macrocytic anaemia + mixed upper/lower signs. dx?
B12 def; subacute combined degeneration of the cord
