Iron Deficiency Anaemia

Question 1

Epidemiology of IDA

Answer 1

IDA is the most common cause of anaemia worldwide.

Adolescent women and women of reproductive age are most at risk.

Question 2

Aetiology of IDA

Answer 2

Blood loss, e.g. menorrhagia or GI bleeding
Hookworm infection (causes GI bleeding)
Pregnancy (increased needs)
Inadequate dietary intake (infants on cows milk, vegan diet)
Malabsorption (e.g. coeliac disease)

Question 3

Symptoms of IDA

Answer 3

Fatigue
Weakness
Chest Pain or Palpitations on exertion
Pica- craving for non-nutritious substances, e.g. ice, clay

Question 4

Signs of IDA

Answer 4

Conjunctival Pallor 
Atrophic Glossitis
Angular Cheilosis 
Tachycardia 
Koilonychia

Question 5

What is Plummer Vinson Syndrome?

Answer 5

Triad of IAD, oesophageal webs and dysphagia

Question 6

Blood Film in IDA

Answer 6

Microcytic, hypochromic anaemia w/ anisocytosis and poikilocytosis

Question 7

Labs in IDA

Answer 7

Hb, MCV, MCH, MCHC all low
Hct low
RDW high
Iron studies: serum iron, ferritin low, TIBC high, transferrin saturation low

Question 8

Other investigations for IDA

Answer 8

If GI bleeding suspected, investigate further.
Also do coeliac screen
Stool microscopy for ova in hookworm infection

Question 9

Treatment

-How much should Hb rise by?

Answer 9

Oral supplementation, e.g. ferrous sulphate
Hb rises by 10g/L/week w/ modest reticulocytosis
Continue until Hb normal and for at least 3 month