IDA Flashcards
Clinical examination for signs of iron deficiency;
?.
? ?-itis.
? nails/ hair.
koilonychia
angular stomatitis
brittle
Further Tests:
Iron Studies: serum ?, serum ?, total iron ? capacity, serum soluble ? receptors.
? ?: microcytic anaemia generally also ? (?, representing low MCH).
o may show ?/ signs of ?
iron ferritin binding transferrin blood film hypochromic pale sideroblasts thalassaemia
? common cause of anaemia worldwide, due to the body’s limited ability to ? ? Iron, and also the frequent loss of Iron in ?.
IDA develops when there is inadequate iron for haemoglobin ?.
There is a ‘? iron deficiency’ period, where ? Hb is maintained despite the iron deficiency.
most take up haemorrhage synthesis latent normal
Causes;
o Blood ? : ? the most common cause worldwide, in the UK most commonly due to heavy ? or ? bleeds.
o Decreased ?: e.g. in ?, patients on ? (less ferric to ferrous iron conversion), or post ?.
loss hookworm menstruation GI absorption coeliacs antacids gastrectomy
Causes;
o Increased ?: in growth/ ?.
o Inadequate ?: rare in the developed world, ? infants/prolonged ? infants most at risk.
demand preg intake prem breastfed
Diagnosis; . . - Blood film : ?, ? cells with poikilocytosis (? variation) and anisocytosis (? variation). Serum iron: ?. Total iron binding capacity: ?. Serum ferritin: ?. -----> o Represents amount of ? iron. Soluble transferrin receptor: ?. -----> o Most ? test, not always available.
microcytic, hypochromic shape size decreased increased decreased stored increased specific
Anaemia of chronic disease can be microcytic or normocytic, and is a differential for IDA;
Serum iron will be ?.
TIBC will be ?, and STR will be ?.
Ferritin will be ?.
decreased
decreased
normal
raised
Raised Ferritin….
o This represents increased ? iron, but it is an acute ? ?, and raises in ? or ?.
o If ferritin is low-normal in the presence of raised ? ? then this can be a false negative, and may suggest ?.
stored phase reactant malig/inf inflam markers ida
If there is a good history of ? start oral iron, with the only further investigation necessary being ? serology.
o Ask about number of ? items used, ? etc.
In all other patients without an obvious cause of bleeding, check ? serology then refer all patients for GI investigation.
o ? & ?.
Stool microscopy is also advised if recent ? ?.
menorrhagia coeliac sanitary clots coeliac ogd, colonoscopy foreign travel
Mx
Oral ? sulphate ?mg ?.d.s., and commence this ? investigation results.
o Can start ?.d. as better tolerated.
Advise increased dietary intake of dark ? vegetables, ? bread /cereals, ? ? meat and prunes/ ?.
ferrous 200 t before b green fortified lean red raisins
Mx
If ferrous sulphate is not tolerated, consider switching to ferrous ?.
o Common side effects are GI-related: ?, ?, nausea, vomiting, ? and ? stools. ‘
o Adverse effects can be decreased if taken with ?, offering ? for constipation or dose ?.
gluconate cramping bloating constipation dark meals laxatives reduction
Mx
Monitor for improvement in symptoms and blood parameters after 1 ?;
o There should be a Hb increase of ?g/L in this time period.
Treatment should be continued for 3 ? after blood parameters return to normal, to replenish supplies.
month
20
months
