Microcytic Anaemia Flashcards
What foods are high in iron?
Red meat, liver, leafy green vegetables, lentils, beans, nuts and seeds.
What are the causes of iron deficiency anaemia?
- Blood loss - menorrhagia or GI bleed
- Poor diet
- Malabsorption - coeliac
- Hookworm in the tropics - GI blood loss
What are the rare signs of iron deficiency anaemia?
Koilonychia, glossitis, angular stomatitis.
How is a suspected iron deficiency anaemia investigated?
Coeliac screen, faecal occult blood test, OGD/colonoscopy in men and post-menopausal women.
What are the findings on a blood film in iron deficiency anaemia?
- Microcytic, hypochromic anaemia
- Low MCV, MCH, MCHC
- Confirmed by low ferritin, high TIBC, low TSAT
What is the treatment for iron deficiency anaemia?
- Treat cause
- Oral iron - ferrous sulphate 200mg/8h alternate days and vitamin C
- IV iron indicated if the oral route is ineffective (functional iron deficiency in CKD)
What are the side effects of oral ferrous sulphate?
Nausea, abdominal discomfort, diarrhoea, constipation, black stools.
What is the most common anaemia in hospital patients?
Anaemia of chronic disease
What are the three mechanisms in anaemia of chronic disease and which substance plays a key role?
- Poor use of iron in erythropoiesis
- Cytokine-induced shortening of RBC survival
- Production of and response to EPO
Hepcidin plays a key role in all three.
What are the causes of anaemia of chronic disease?
- Chronic infection/inflammation
2. Vasculitis, rheumatoid, malignancy, renal failure.
What are the results of ferritin and MCV in anaemia of chronic disease?
- Ferritin - normal/raised
2. MCV - normal or low (normocytic/microcytic)
What is the treatment for anaemia of chronic disease?
- Treat underlying cause
- EPO may help
- IV iron can overcome functional iron deficiency
