Management

Question 1

What is the long-term management of sickle cell disease?

Answer 1

• Keep warm/hydrated/regular hours
• Eat well
• Penicillin and folic acid (penicillin due to patients becoming hyposplenic and spleen auto-infarcts causing increased risk of infections)

Question 2

How should IDA be treated?

Answer 2

• Underlying cause determined and treated
• Oral ferrous sulfate 200mg tablets 2/3 times per day (continue for 3 months after ID corrected), Hb levels should be checked 2-4 weeks to assess response to treatment

Question 3

When should patients be referred for suspected cancer pathway on 2WW?

Answer 3

• People aged over 60yrs with IDA
• Women over 55yrs with postmenopausal bleeding

Question 4

How is folate deficiency anaemia treated?

Answer 4

Oral folic acid 5mg daily - 4 months or longer. Also provide dietary advice e.g. eat more broccoli, asparagus, peas, chickpeas

Question 5

How is Vit B12 deficiency anaemia treated?

Answer 5

Hydroxycobalamin 1mg intramuscular every 3 months for life (when not diet related).
Maintenance treatment with oral cyanocobalamin tablets or biannually hydroxycobalamin 1mg injection (diet related)