Iron Deficiency Anaemia

Question 1

what causes iron deficiency anaemia

Answer 1

blood loss

diet

pregnancy

poor absorption e.g. GI problems

Question 2

how does iron deficiency anaemia present

Answer 2

fatigue
SOB
palpitations
pale skin 
angular cheilitis

koilonychia

Question 3

how would blood tests come back in iron deficiency anaemia

Answer 3

low Hb

low MCV

low mean corpuscular haemoglobin (MCH)

low ferritin

low iron

Question 4

how do you investigate iron deficiency anaemia

Answer 4

blood tests:

• total iron binding capacity (blood test) would be high
• low ferritin
• low MCV
• low Hb

?colonoscopy/ endoscopy

Question 5

how do you manage iron deficiency anaemia

Answer 5

iron infusion

oral iron (ferrous sulphate)- not indicated if malabsorption is the cause

blood transfusion - correct anaemia but not the iron deficiency

Question 6

why can PPIs give you iron deficiency

Answer 6

stomach acid keeps iron in the soluble ferrous (Fe2+) form

when acid levels are low it changes to ferric (Fe3+) form

so PPIs reduce the amount of acid and so make iron more difficult to absorb causing iron deficiency

Question 7

explain what someones Total Iron Binding Capacity means

Answer 7

iron is carried in the blood in its ferric (Fe3+) form by transferrin

the TIBC is the total space on the transferrin molecule for iron to bind

so the TIBC is directly related to the amount of transferrin in the blood

Question 8

what is ferritin

Answer 8

the form that iron takes when it is deposited and stored in cells

extra ferritin is released form cells during times of inflammation so can indicate infection or cancer

ferritin levels gives an indication of how iron deficienct you are