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Fe deficiency
anaemia (Clinical
presentation (SOB, Palpitations, Fatigue…
Fe deficiency
anaemia
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Aetiology
Vascular
Blood loss i.e. GI bleed, menses
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Diagnosis
Examination
Abdo exam
Koilonychia, pallor, pale conjunctiva,
glossitis, angular stomatitis
Investigations
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Bloods
FBC - microcytic (low Hb, low MCV)
Fe studies - low ferritin, low Fe, high TIBC
(ferritin is acute phase protein so inc in inflammation)
Film - microcytic, hypochromic RBCs
Coeliac serology - exclude malabsorption
Imaging
Indication: if GI loss suspected
e.g. gastroscopy, sigmoidoscopy, colonoscopy
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History
PC/HPC
Fatigue, SOB, palpitations, syncope
PMH
Coeliac, heavy periods,GI bleeds,
known medical conditions
DH
Meds, prev Fe tx, allergies
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SH
Living arrangements,
occupation, diet, alcohol, smoking
Management
Medical
Fe replacement
Indication: Fe deficiency
E.g. ferrous sulphate
MOA: replaces Fe stores; aim 10g/L/wk,
until stores replenished and >3m after
SEs: black stools, nausea,
diarrhoea/constipation, abdo pain
Conservative
Identify and treat cause
Diet (iron intake e.g. dairy, meat, green leafy veg, beans and pulses, nuts and seeds; avoid tea (tannins))