IDA Lab Test

Question 1

aim to detect the anemia before it becomes severe.

A _______is typically used, revealing changes in red blood cells (RBCs) that indicate iron deficiency

Answer 1

Screening tests

complete blood count (CBC)

Question 2

IDA screening

• Indicators in the CBC:: Variation in RBC size.: Smaller-than-normal RBCs.: Pale RBCs due to low hemoglobin.: Early sign showing variability in RBC size, often exceeding 15%.
  : Indicators that the anemia is worsening.

Answer 2

• Anisocytosis
• Microcytosis
• Hypochromia
• Increased RDW (Red Cell Distribution Width)
• Declining Hemoglobin, MCV, MCH, and MCHC

Question 3

Screening Tests

Screening for IDA focuses on changes in red blood cell (RBC) indices, morphology, and other hematologic findings:

1. Hemoglobin Concentration
   • _______hemoglobin is a key indicator of anemia.
   • Helps assess the severity of IDA.
2. Red Cell Distribution Width (RDW)
   • RDW____ indicates significant variation in RBC size (______).
   • RDW increases early in IDA as new smaller cells (_______RBCs) are produced.
3. Progressive Decline of RBC Indices
   • ______: Smaller-than-normal RBCs (decreased Mean Corpuscular Volume, MCV).
   • _______: Paler RBCs due to reduced hemoglobin content (decreased Mean Corpuscular Hemoglobin, MCH).
4. RBC Count
   • ______slowly as the anemia progresses.
5. Polychromasia
   • Increased _______may appear early in IDA but is not a prominent feature.
6. ________
   • Abnormal shapes of RBCs may be present, but no specific shape is characteristic of IDA.
7. _____-
   • Elevated platelet count is often observed, especially in cases of chronic bleeding.
8. White Blood Cell (WBC) Count
   • Remains______ in most cases of IDA.

Answer 3

Decreased

> 15%; anisocytosis; microcytic

Microcytosis; Hypochromia

Decreases

reticulocytes (young RBCs)

Poikilocytosis

Thrombocytosis

normal

Question 4

Diagnostic Testing: Confirming Iron Deficiency

Answer 4

Serum Iron

Total Iron-Binding Capacity (TIBC)

Transferrin Saturation

Serum Ferritin

Question 5

Diagnostic testing

• ASSAYS:
1.______: measure of the amount of iron bound to transferrin (transport iron) in the serum
2._______
• Indirect measure of transferrin and the available binding sites for iron
3.______:
• % of transferrin binding sites occupied by iron
4. _______
• Intracellular storage repository for metabolically active iron

Answer 5

SERUM IRON

TIBC (TOTAL IRON-BINDING CAPACITY)

TRANSFERRIN SATURATION

SERUM FERRITIN

Question 6

Measures the amount of iron bound to transferrin (a protein that transports iron).

Answer 6

Serum Iron:

Question 7

Reflects the availability of transferrin binding sites for iron.

Answer 7

TIBC (Total Iron Binding Capacity):

Question 8

: Percentage of transferrin binding sites occupied by iron; this value decreases in iron deficiency.

Answer 8

Transferrin Saturation

Question 9

: Indicates the body’s stored iron.

A low ferritin level strongly suggests iron deficiency.

Answer 9

Serum Ferritin

Question 10

IDA Diagnostic

• Key Patterns in Results:
  
  • Low____ and _____
  • High_____ and low _____as the liver tries to compensate for the deficiency.

Answer 10

serum ferritin and serum iron levels.

TIBC

transferrin saturation

Question 11

• NOT COMMONLY USED
• Show abnormalities that become important in the differential diagnosis of similar conditions
• Accumulated porphyrin to heme are elevated

Answer 11

SPECIALIZED TEST

Question 12

SPECIALIZED TEST (4)

Answer 12

1. FREE ERYTHROCYTE PROTOPORPHYRIN (FEP)
2. SOLUBLE TRANSFERRIN RECEPTORS (sTfR)
3. BONE MARROW ASSESSMENT
4. THERAPEUTIC TRIAN

Question 13

• Accumulates when iron is unavailable
• Chelates with zinc => zinc protoporphyrin (ZPP).
• Assayed fluorometrically

Answer 13

FREE ERYTHROCYTE PROTOPORPHYRIN (FEP)

Question 14

• Can be assayed using immunoassays
• Levels decrease as the disease progresses
• Cells seek to take in as much as possible

Answer 14

SOLUBLE TRANSFERRIN RECEPTORS (sTfR)

Question 15

• Is NOT indicated for suspected uncomplicated iron deficiency
• Routinely performed when BM specimen is collected for other reasons

Answer 15

BONE MARROW ASSESSMENT

Question 16

• IRON DEFICIENCY IN BONE MARROW:

•: hyperplastic, decrease M:E ratio due to increase erythropoiesis

•: hyperplasia subsides, deficient iron leads to slowed RBC production

Answer 16

EARLY

PROGRESSION

Question 17

IDA in BM

• ______show the most dramatic morphologic changes

• ______maturation lagging behind nuclear maturation

• Cytoplasm remains_____ after the nucleus had begun to condense

• Cell membrane appear irregular and usually describe as “_____”

Answer 17

Polychromatic normoblasts

Nuclear-cytoplasmic

bluish

shaggy

Question 18

• Provides a less invasive and less expensive diagnostic assessment

Answer 18

THERAPEUTIC TRIAN

Question 19

Measures the amount of hemoglobin in young RBCs (reticulocytes).

It detects iron deficiency early, even before anemia develops.

Answer 19

Reticulocyte Hemoglobin Content

Question 20

: In iron deficiency, the body uses zinc instead of iron to form hemoglobin, leading to higher ZPP levels.

Answer 20

Zinc Protoporphyrin (ZPP)

Question 21

are immature RBCs that indicate how well the body is producing new RBCs.

If their hemoglobin content is low, it suggests iron-restricted erythropoiesis.

This tests are particularly useful for identifying iron deficiency during its latent (early) stage.

Answer 21

Reticulocytes

Question 22

are immature RBCs that indicate how well the body is producing new RBCs.

If their hemoglobin content is low, it suggests iron-restricted erythropoiesis.

These tests are particularly useful for identifying iron deficiency during its latent (early) stage.

Answer 22

Reticulocytes