Iron deficiency anaemia

Question 1

How do RBC look in iron deficiency anaemia?

Answer 1

Microcytic, hypochromic

Question 2

What are the signs and symptoms of IDA?

Answer 2

Pallor
Palps
SOB
Easily fatigued
Koilonychia
Hair loss 
Pica
Glossitis

Question 3

What physiological parameters are decreased in IDA?

Answer 3

Hb
MCV
MCH
Ferritin
Serum iron

Question 4

What physiological parameters are increased in IDA?

Answer 4

Total iron binding capacity

RBC distribution width

Question 5

What are the four categories of causes of IDA?

Answer 5

Decreased intake, decreased absorption, increased demand, increased loss

Question 6

What are the causes of decreased intake IDA?

Answer 6

Infants - decreased iron in breast milk

Vegetarians - non-heme iron more difficult

Question 7

What are the causes of decreased absorption IDA?

Answer 7

Decreased HCl production

IBD/coeliac disease - repeated inflammation causes destruction of duodenal cells

Question 8

What are the causes of increased demand IDA?

Answer 8

Children - growth
Adolescents - growth
Pregnancy - due to increased foetal demand

Question 9

What are the causes of increased loss IDA?

Answer 9

Chronic slow bleeds - heavy periods, gastric ulcers, colon cancers (often first symptom)
H pylori infections
Hookworms (in developing countries)

Question 10

What is the management for IDA?

Answer 10

Treat the cause!
Oral iron supplements - ferrous sulphate, taken with orange juice to aid absorption, if not tolerated try different iron eg ferrous fumarate, if not tolerated consider IV iron, or a blood transfusion if severe anaemia