Haematology 2 - Iron Deficiency Anaemia

Question 1

4 root causes of iron deficiency

Answer 1

apply to any deficiency really

insufficient intake
increase in bodily demand
loss through bleeding
poor absorption

Question 2

why do PPIs interfere with iron absorption?

Answer 2

acidic conditions are needed to keep iron in its soluble Fe2+ form

Question 3

why do coeliac and Chron’s interfere with iron absortion

Answer 3

iron is absorbed in the duodenum and jejunum and these diseases affect these areas

Question 4

common causes of bleeding you should consider with iron deficiency anaemia

Answer 4

dysmenorrhoea
GI bleeds - cancer, oesophagitis, gastritis
IBD

Question 5

describe iron transport around the body

Answer 5

transported as Fe3+ bound to transferrin

stored in cells as ferritin (ferritin released in inflammation)

Question 6

iron studies results iron deficient

Answer 6

low ferritin
high total iron-binding capacity
low transferrin saturation

ferritin may be normal even with deficiency as can be raised by other things

Question 7

iron studies results iron excess

Answer 7

high ferritin
low TIBC
high transferrin saturation

Question 8

what should be done with new IDA without clear cause?

Answer 8

2 week wait OGD + colonoscopy - cancer screen

Question 9

treating iron deficiency anaemia

Answer 9

in extremis, transfusion
iron infusion
200mg ferrous sulphate TDS

Hb goes up by 10 per week on tablets