Iron Deficiency

Question 1

Name the anemias of decreased erythropoiesis

Answer 1

1. Iron
2. Megaloblastic
3. Anemia of chronic disease
4. Aplastic
5. Myelophthisic

Question 2

How much iron is lost from body daily?

Answer 2

2mg/ day from epithelial shedding

Question 3

Where is iron absorbed ?

Answer 3

DUODENUM

B12 in ileum

Question 4

What are causes of iron def. anemia?

Answer 4

NUTRITION: 1) poor diet e.g socioeconomic, vegetarians
2) malabsorption e.g celiac, sprue, gastrectomy, decrease acid, more calcium or tannic acid
DEMAND: 1) physio e.g infant, growth, elderly, menses, preg, birth, lactation.
2) patho e.g menorrhagia, hemoroids, ulcers, malignancy, hookworm infestation.

Question 5

What do the labs show?

Answer 5

Anemia ( male: 13-18g/dl.. female: 11.5-16g/dl)
Iron low (<2.5g female and <3.5g in male)
Ferritin low
TIBC high
Iron saturation low

Question 6

What are microcytic anemias?

Answer 6

T. Thalassemia 
A. Anemia of chronic disease 
I. Iron
L. Lead poisoning 
S. Siderosis

Question 7

What is MCV?

Answer 7

Mean corpuscular volume
82-92 femtolitre (fL)
Less than 82 is micro

Question 8

What is seen in peripheral smear?

Answer 8

Microcytic
Hypochromic
INCREASED central pallor

Question 9

What is the sequence of lab finding?

Answer 9

In the start iron is low so stored iron is utilised. Our first finding would be
LOW FERRITIN —>HIGH TIBC
LOW IRON—> LOW IRON SATURATION

Question 10

How do you treat iron def. anemia

Answer 10

No blood transfusion until cardiac symptoms occur e.g heart failure, cerebral hypoxia
So, dietary advice:more eggs, meat, grean Leafy veggies
Supplements: 200mg thrice a day for 3 to 6 months of FERROUS SULFATE
If side effects lower frequency to twice a day
IV options include iron isomaltose and iron carboxymaltose