Microcytic anaemia

Question 1

What are the normal ranges of haemoglobin in the blood

Answer 1

• women: 120-165 g/L
• men: 130-180 g/L

Question 2

Give 5 causes of microcytic anaemia

Answer 2

T – Thalassaemia
A – Anaemia of chronic disease
I – Iron deficiency anaemia
L – Lead poisoning
S – Sideroblastic anaemia

Question 3

Why is iron important for the body?

Answer 3

Iron is needed to make haemoglobin in red blood cells. A deficiency leads to a reduction in red blood cells/haemoglobin, causing anaemia.

Question 4

Which group has the highest incidence of iron deficiency anaemia?

Answer 4

Preschool-age children.

Question 5

What are the main causes of iron deficiency anaemia?

Answer 5

• Excessive blood loss
• inadequate dietary intake
• poor intestinal absorption (e.g. coeliac)
• increased iron requirements (pregnancy)

Question 6

What is the most common cause of excessive blood loss in pre-menopausal women?

Answer 6

Menorrhagia

Question 7

What is the most common source of excessive blood loss in men and post-menopausal women?

Answer 7

Gastrointestinal bleeding:
* Cancer
* Oesophagitis and gastritis
* Peptic ulcers
* Inflammatory bowel disease

Question 8

What are common symptoms of iron deficiency anaemia?

Answer 8

• Fatigue
• shortness of breath
• palpitations
• pallor
• nail changes (e.g., koilonychia)
• hair loss
• atrophic glossitis
• angular stomatitis.

Question 9

What does a Full Blood Count (FBC) show in iron deficiency anaemia?

Answer 9

Hypochromic microcytic anaemia

Question 10

What is ferritin and what is its role in iron storage?

Answer 10

Ferritin is a protein that stores iron inside cells

Question 11

How are serum ferritin levels used in the diagnosis of iron deficiency anaemia

Answer 11

• Low serum ferritin is highly suggestive of iron deficiency as it correlates with iron stores
• normal/ raised serum ferritin doesn’t rule out iron deficiency anaemia

Question 12

What conditions can cause raised ferritin levels?

Answer 12

inflammation
liver disease
iron supplements
haemochromatosis

Question 13

What is transferrin and what role does it play in iron transport?

Answer 13

Transferrin is a carrier protein that binds iron and transports it through the blood.

Question 14

What does Total Iron-Binding Capacity (TIBC) represent?

Answer 14

• TIBC refers to the total space available for iron to bind on all transferrin molecules combined
• It is directly related to the amount of transferrin in the blood.

Question 15

How are TIBC and transferrin values used in the diagnosis of iron deficiency anaemia

Answer 15

• TIBC and transferrin levels will be high (this indicates low iron stores)
• transferrin saturation will be low

Question 16

What does a blood film in iron deficiency anaemia typically show?

Answer 16

Anisopoikilocytosis (varied red blood cell sizes and shapes), target cells, and ‘pencil’ poikilocytes.

Question 17

What is the management for iron deficiency anaemia?

Answer 17

• Identifying and managing the underlying cause (exclude malignancy)
• Oral ferrous sulfate supplementation
• iron-rich diet: dark-green leafy vegetables, meat

Question 18

How long should iron supplementation continue after correcting iron deficiency?

Answer 18

For 3 months to replenish iron stores.

Question 19

What are common side effects of iron supplementation?

Answer 19

nausea
abdominal pain
constipation
diarrhoea