vitamin, mineral and trace element deficiencies

Question 1

people with a medical condition affecting the GI tract

Answer 1

short bowel syndrome
pancreatic insufficiency
inflammatory bowel disease
untreated coeliac disease
chronic vomiting
gastroparesis
bariatric surgery or other surgery to the small bowel or stomach

Question 2

people at risk of deficiencies due to inadequate intake or high requirement

Answer 2

pregnant people
elderly people
vegans
people with high alcohol intake
chronic liver disease
eating disorders
people on a restrictive diet

Question 3

causes of iron deficiency

Answer 3

inadequate dietary intake of iron (eg. toddlers and adolescents, people with a vegan or vegetarian diet, anorexia nervosa)
malabsorption (coeliac disease, pernicious anaemia, gastrectomy or bariatric surgery)
increased iron requirements (eg. pregnancy, breastfeeding, during periods of rapid growth, heavy menstrual loss or chronic gastrointestinal blood loss)

Question 4

symptoms of iron deficiency

Answer 4

fatigue
microcytic hypochromic anaemia
pica
restless leg syndrome
breathlessness, angina, claudication

Question 5

diagnosis of iron deficiency

Answer 5

serum iron concentrations do not reflect total body stores
the best measure of total body iron stores is serum ferritin, which is low in iron deficiency

Question 6

ferritin may be elevated in

Answer 6

patients with acute or chronic inflammatory conditions or infections
iron deficiency is still unlikley if ferritin is above 100

Question 7

when to use red blood cell transfusion

Answer 7

red blood cell transfusion alone is not appropriate treatment for iron deficiency anaemia
blood transfusions may be used for decompensated patients eg. those with heart failure or angina who are too unwell to wait for predictable increase in haemaglobin from iron supplimentation