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Paediatrics > Iron Deficiency Anaemia > Flashcards

Iron Deficiency Anaemia Flashcards

1
Q

What is anaemia defined as?

A

A Hb below the normal range

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2
Q

Is the normal Hb range consistent with age?

A

No, it varies

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3
Q

What is anaemia defined as in neonates?

A

Hb below 140g/L

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4
Q

What is anaemia defined as in children aged 1 month-12 years?

A

Hb below 100g/L

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5
Q

What is anaemia defined as in children aged 1 year to 12 years?

A

Hb less than 110g/L

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6
Q

What can anaemia result from?

A

A number of different mechanisms

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7
Q

Give an example of a mechanism by which anaemia can result?

A

Reduced red cell production due to ineffective erythropoiesis

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8
Q

What can cause reduced red cell production due to ineffective erythropoiesis?

A

Iron deficiency

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9
Q

What is the importance of iron deficiency as a cause of anaemia?

A

It is one of the most common causes of anaemia

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10
Q

What is iron?

A

A mineral

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11
Q

What is iron important for?

A

Formation of red blood cells in the body, particularly as a critical component of haemoglobin

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12
Q

How is iron absorbed?

A

Primarily in the small intestine, in particular the duodenum and jejenum

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13
Q

What happens to iron after being absorbed in the small intestine?

A

It travels through the blood bound to transferrin, and eventually ends up in the bone marrow, where it is involved in RBC formation

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14
Q

What happens to iron when RBCs are degraded?

A

The iron is recycled by the body and stored

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15
Q

What are the main causes of iron deficiency?

A
  • Inadequate intake
  • Malabsorption
  • Blood loss
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16
Q

Who is inadequate iron intake common in?

A

Infants

17
Q

Why is inadequate iron intake common in infants?

A

Because additional iron is required for the increase in blood volume accompanying growth, and to build up the child’s iron stores

18
Q

What sources might iron come from?

A
  • Breastmilk
  • Infant formula
  • Cow’s milk
  • Solid’s introduced at weaning
19
Q

Describe the iron content of breastmilk

A

It has a low iron content, but 50% is absorbed

20
Q

Describe the iron content of infant formula

A

It is supplemented with adequate amounts of iron

21
Q

Describe the iron content of cow’s milk

A

It has a higher content than breastmilk, but only about 10% is absorbed

22
Q

In terms of diet, why might iron deficiency occur?

A
  • Introduction of mixed feeding beyond 6 months old

- Diet with insufficient iron-rich foods

23
Q

When is iron absorption markedly increased?

A

When eaten with food rich in vitamin D

24
Q

When are most infants and children asymptomatic until?

A

Hb drops below 60-70g/L

25
Q

What happens to presentation as anaemia worsens and becomes symptomatic?

A
  • Children tire easily
  • Young infants feed more slowly than normal
  • Appear pale
  • Pica
26
Q

Is pallor a reliable sign in anaemia?

A

Not unless it is confirmed by pallor of the conjunctivae, tongue, or palmar creases

27
Q

What is pica?

A

Inappropriate eating of non-food materials

28
Q

Does iron deficiency anaemia affect cognition?

A

There is evidence that iron deficiency anaemia may be detrimental to behaviour and intellectual function

29
Q

What should the history include in iron deficiency anaemia?

A

Asking about blood loss and symptoms/signs suggestive of blood loss

30
Q

What might the FBC show in iron deficiency anaemia?

A
  • Low MCV
  • Low mean cell haemoglobin
  • Low serum ferritin
31
Q

What are the differential diagnoses of microcytic anaemia?

A
  • ß-thalassaemia

- Anaemia or chronic disease, e.g. due to CKD

32
Q

What does the management of iron deficiency anaemia involve for most children?

A
  • Dietary advice

- Supplementation with oral iron

33
Q

Give 4 examples of iron rich foods

A
  • Red meat
  • Liver
  • Kidney
  • Oily fish
34
Q

By how much should iron supplementation increase Hb with good compliance?

A

Around 10g/L/week

35
Q

What are the best tolerated preparations of iron supplementation?

A
  • Sytron

- Niferex

36
Q

What can cause failure to respond to iron supplementation?

A

Usually indicates poor compliance, but other causes, e.g. malabsorption, chronic blood loss, should be considered

37
Q

Is blood transfusion necessary for dietary iron deficiency?

A

It should never be

38
Q

Why should blood transfusion never be necessary for dietary iron deficiency?

A

Because even children with a Hb as low as 20-30g/L due to iron deficiency have gradually reached this level, and therefore can tolerate it

39
Q

What are the complications of iron deficiency anaemia?

A

Problems with growth and development

Paediatrics (115 decks)

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