Iron deficiency anaemia Flashcards
1
Q
What is the definition of iron deficiency anaemia?
A
↓ red blood cell count due to ↓ iron
2
Q
How common is iron deficiency anaemia?
A
Common
3
Q
What is the pathophysiology of iron deficiency anaemia?
A
- Fe is required for the formation of the haem in haemoglobin, myoglobin, haem enzymes and cytochromes
- Normal to lose a small amount each day in faeces, skin cells and mucosa
- Iron is absorbed in the jejunum and stored in the form of ferritin
- If more iron lost than absorbed, iron stores used up = deficiency
4
Q
What are the risk factors/aetiology of iron deficiency anaemia?
A
- Blood loss e.g. menorrhagia/GI bleed
- Poor diet – mainly in children
- Special diet
- Poverty
- Malabsorption e.g. coeliac disease
- Tetracyclines/quinolones – neither iron of antibiotic is absorbed
- Antacids/PPI – impairs absorption as raises Ph
- Phytate (wholegrain cereals, nuts etc), polyphenols (tea/coffee), calcium – impair iron absorption
- Partial/total gastrectomy
- H.pylori – impairs iron uptake
- Hookworm – in the tropics
- GI carcinoma
- Times of rapid growth in children - ↑ requirements
- Pregnancy - ↑ requirements
- Exfoliative skin disease - ↑ requirements
5
Q
What are the signs/symptoms of iron deficiency anaemia?
A
- Koilonychia – spoon shaped nails
- Atrophic glossitis
- Angular cheilosis – ulcerations in the corner of the mouth
- Pale conjunctiva
- Pale skin
- Pale palmar creases?
- Tiredness
- SOB
- Palpitations
- Headache
- Changes in hair/hair loss
6
Q
What investigations are carried out for suspected iron deficiency anaemia?
A
- FBC – microcytic hypochromic anaemia, ↓ MCV, MCH and MCHC
- ↓ Serum Ferritin
- ↑ Red cell protoporphyrin
- Gastroscopy – GI bleed
- Signmoidoscopy – GI bleed
- Colonoscopy – GI bleed
- Stool microscopy - hookworm
7
Q
What are the pharmacological treatments for iron deficiency anaemia?
A
- Blood transfusion
* Ferrous sulfate
8
Q
What are the non pharmacological treatments for iron deficiency anaemia?
A
• Iron rich diet e.g. green vegetables, meat, raisins, prunes etc