Anaemia & Iron Deficiency – Exam Flashcards (16 max)

Define anaemia.

Haemoglobin concentration below the normal reference range.

What are the 3 principal mechanisms causing anaemia?

1. Increased red cell loss

2. Failure of red cell or haemoglobin production

3. Reduced red cell lifespan (haemolysis)

What key information does the FBC provide in anaemia?

Hb level, RBC count, MCV (size), MCH/MCHC (chromicity), WBC and plate revealed associated pathology.

: How is anaemia classified by MCV?

• Microcytic (<80 fL)

• Normocytic (80–100 fL)

• Macrocytic (>100 fL)

What blood film features suggest iron deficiency anaemia (IDA)?

Microcytic, hypochromic red cells with anisocytosis (↑ RDW).

What is the role of the reticulocyte count in anaemia investigation?

increase Retics → haemolysis or blood loss and decrease Retics → marrow failure or impaired production

Typical laboratory findings in haemolytic anaemia?

Normocytic anaemia, raised retics, polychromasia, spherocytes/fragments, NRBCs

What causes microcytic hypochromic anaemia?

Iron deficiency, thalassaemia, sideroblastic anaemia, anaemia of chronic disease

Where is iron found in the body?

60% in haemoglobin, 25% in storage (ferritin) 15% in myoglobin & enzymes

Describe iron absorption and transport.

Absorbed in duodenum → transported by transferrin → used in marrow or stored as ferritin.

What is ferritin and what does it reflect?

Intracellular iron storage protein; serum ferritin reflects iron stores.

What is hepcidin and known for?

Liver hormone that reduces iron absorption and release by degrading ferroportin.

How does inflammation affect iron levels?

Increase IL-6 → ↑ hepcidin → decrease iron availability (anaemia of chronic disease).

Key laboratory findings in iron deficiency anaemia?

things that decrease: Hb, MCV, MCH, ferritin and things that increase RDW, ZPP, TIBC, transferrin saturation.

First-line treatment for iron deficiency anaemia?

Oral iron (e.g. ferrous sulphate) with Hb rise ≈ 20 g/L every 3 weeks.

: When is IV iron or transfusion indicated?

• IV iron: malabsorption, intolerance, urgent need

• Transfusion: severe symptoms or urgent Hb correction only

Core principles of treating anaemia, What are the core principles of treating anaemia?

Identify the cause, treat the underlying pathology, support oxygen delivery if needed, and avoid unnecessary transfusion.

Anaemia due to blood loss

Q: How is anaemia caused by blood loss managed?

Stop bleeding, correct coagulopathy, iron replacement, transfusion only if clinically indicated.

Haemolytic anaemia

Q: How is haemolytic anaemia managed?

Remove trigger (e.g. drugs), avoid haemolytic stressors, transfusion if severe, splenectomy in selected cases.

Bone marrow failure anaemia

Q: How is bone marrow failure–related anaemia managed?

Supportive transfusion, treat underlying disease, consider HSCT for definitive management.