Anemia and Iron Deficiency Overview

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Questions and Answers

Which of the following factors is associated with nutritional anemias?

Iron deficiency (correct)

Bone marrow abnormalities

Infection

Renal failure

What type of anemia is characterized by hypochromic microcytic red blood cells?

Folic acid deficiency anemia

Aplastic anemia

Iron deficiency anemia (correct)

Sickle cell anemia

What is the preferred form of iron for oral supplementation due to its absorption efficiency?

Ferric iron

Ferrous iron (correct)

Iron dextran

Iron sucrose

How long should oral iron therapy be continued to correct iron deficiency anemia?

3–6 months Signup and view all the answers

What is the primary reason for choosing parenteral iron therapy?

For patients who cannot absorb oral iron Signup and view all the answers

What are common side effects of oral iron therapy?

Nausea and black stools Signup and view all the answers

How much elemental iron is typically needed daily to correct iron deficiency anemia?

50–100 mg Signup and view all the answers

What is the composition of iron dextran in parenteral iron therapy?

Ferric oxy-hydroxide and dextran Signup and view all the answers

What is a potential consequence of administering folic acid alone in the presence of vitamin B12 deficiency?

It masks the vitamin B12 deficiency. Signup and view all the answers

Which of the following vitamins is crucial for DNA synthesis and red blood cell production?

Vitamin B12 Signup and view all the answers

What can lead to vitamin B12 deficiency due to malabsorption?

Failure of gastric parietal cells to produce intrinsic factor Signup and view all the answers

Which is the preferred form of vitamin B12 for parenteral injection, and why?

Hydroxocobalamin, due to its longer circulation half-life. Signup and view all the answers

What is the usual daily requirement for vitamin B12 in micrograms?

2 mcg Signup and view all the answers

Which common condition can lead to impaired absorption of vitamin B12?

Chronic pancreatitis Signup and view all the answers

Which of the following is NOT a typical side effect of vitamin B12 administration?

Respiratory distress Signup and view all the answers

What is the common initial dosage range for vitamin B12 therapy using intramuscular injection?

100–1000 mcg Signup and view all the answers

What are the possible adverse effects of intravenous administration noted in the content?

Fever, arthralgia, and bronchospasm Signup and view all the answers

Which statement regarding sodium ferric gluconate complex and iron-sucrose complex is accurate?

They require intravenous administration only. Signup and view all the answers

What is the first stage of acute iron toxicity?

GIT irritation Signup and view all the answers

Which is a key characteristic of chronic iron toxicity as defined in the content?

It results in hemochromatosis. Signup and view all the answers

What constitutes the supportive therapy for acute iron toxicity?

Whole bowel irrigation and supportive measures Signup and view all the answers

What is the role of deferoxamine in the treatment of acute iron toxicity?

It promotes the excretion of absorbed iron. Signup and view all the answers

What leads to folate deficiency according to the content?

Poor absorption in the small intestine Signup and view all the answers

What is a potential consequence of iron overload if left untreated?

Hepatic necrosis Signup and view all the answers

Study Notes

Anemia

Anemia is defined as a below-normal plasma hemoglobin concentration.
Causes of anemia include nutritional deficiencies (iron, folic acid, vitamin B12), chronic blood loss, bone marrow abnormalities, increased hemolysis, infections, malignancy, chronic diseases (endocrine deficiencies, renal failure), and drug-induced toxic effects on blood cells, hemoglobin production, or erythropoietic organs.
Genetic factors, excessive bleeding (menstrual bleeding, iron deficiency anemia, cancer causing anemia), and impaired metabolism of the spleen and anemia can also contribute to the cause of anemia.

Iron Deficiency Anemia

Iron deficiency is a common cause of chronic anemia.
Iron is crucial for the formation of hemoglobin.
Iron forms the core of the heme group within hemoglobin.
Globin chains combine with heme to form hemoglobin.
Daily iron loss from the body is small, so dietary requirements are modest.

Causes of Iron Deficiency

Diet: Insufficient intake, malnutrition, dietary factors (polyphenols, tannins).
Absorption Issues: Gastritis, celiac disease, enteritis, surgical procedures, drugs, infections.
Blood Loss: Gastrointestinal lesions, cancer, heavy menstrual bleeding, blood donations, hematuria, coagulopathy, inflammatory bowel disease (IBD).
Inflammation: Increased levels of hepcidin.
Increased Needs: Pregnancy, children, athletes, patients undergoing chemotherapy or EPO.
Others: Hemolysis (destruction of red blood cells), various iron metabolism disorders.

Oral Iron Therapy

Ferrous iron is absorbed more efficiently than ferric iron.
Daily iron need is approximately 50-100 mg.
About 25% of oral iron is absorbed, so 200-400 mg of elemental iron is often required daily for effective correction of iron deficiency.
Oral iron therapy should be administered for 3-6 months to replenish iron stores and correct anemia.

Parenteral Iron Therapy

Reserved for patients with intolerance or poor absorption of oral iron, or those with severe chronic anemia.
Parenteral iron formulations include iron dextran, sodium ferric gluconate complex, and iron sucrose.

Iron Toxicity

Primarily affects young children.
Ingestion of even a small number of oral iron tablets can be fatal in children.
Symptoms of acute iron toxicity can include GI irritation, shock, metabolic acidosis, and hepatic necrosis.
Supportive treatment includes measures to manage gastrointestinal bleeding, metabolic acidosis, or shock.
Whole bowel irrigation can be used to flush out unabsorbed pills.
Hemodialysis is not effective for acute iron toxicity as iron has a large volume of distribution.
Exchange transfusion or deferoxamine, an iron chelating drug, might be considered.

Folic Acid Deficiency

Folic acid is vital for DNA synthesis and cell division.
Significant daily requirement is 50 µg.
A deficiency can cause megaloblastic anemia and neuropathies.
Causes of deficiency include increased demand (pregnancy, lactation), poor absorption (intestinal diseases), alcoholism, and medications like methotrexate, pyrimethamine, and trimethoprim.
High doses of folic acid (up to 5mg/day) may be required in certain cases.

Vitamin B12 Deficiency Anemia

Vitamin B12 is crucial for neurological function, red blood cell production, and DNA synthesis.
It is acquired from diet.
B12 absorption occurs in the terminal ileum of the small intestine with the help of intrinsic factor.
Deficiency can cause megaloblastic anemia and neurological abnormalities.
Causes include low dietary intake or poor absorption (pernicious anemia or decreased intrinsic factor production).
Oral or parenteral supplementation is required to treat deficiencies.

Sickle Cell Disease

Agents used to treat sickle cell disease includes hydroxyurea which apparently increases fetal hemoglobin, which can diluted abnormal hemoglobin S (HbS).
Additional agents can include pentoxifylline which improves erythrocyte flexibility and reduces blood viscosity.

Chronic Iron Toxicity

Known as hemochromatosis.
Treatment often involves intermittent phlebotomy.
Deferasirox (an oral iron chelator) is a treatment option for iron overload.

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Description

Explore the various types and causes of anemia, focusing particularly on iron deficiency anemia. Understand how nutritional factors, chronic diseases, and genetic components contribute to the condition. This quiz will help you grasp the fundamentals of hemoglobin formation and the importance of iron in health.