Iron Deficiency Anemia

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Questions and Answers

Match the following causes with the related type of anemia:

Nutritional deficiency (Vitamin B12) = Megaloblastic anemia Faulty iron absorption = Iron deficiency anemia Defects in DNA synthesis = Megaloblastic anemia Excessive blood loss = Iron deficiency anemia

Match the laboratory findings with the type of anemia they indicate:

Decreased serum ferritin = Iron deficiency anemia Macrocytosis = Megaloblastic anemia Increased TIBC = Iron deficiency anemia Hypersegmented neutrophils = Megaloblastic anemia

Match the specific condition with its related potential cause of anemia:

Pregnancy = Both anemias Gastric Resection = Iron deficiency anemia Dietary deficiency of B12 = Megaloblastic anemia Peptic ulcer = Iron deficiency anemia

Match the type of anemia with the key blood film findings:

<p>Hypochromic, microcytic red cells = Iron deficiency anemia Macrocytic red cells with ovelocytes = Megaloblastic anemia Normal reticulocyte count = Iron deficiency anemia Leukocytosis with reduced platelets = Megaloblastic anemia</p> Signup and view all the answers

Match the clinical scenario with the most likely cause of megaloblastic anemia:

<p>Strict vegetarian diet = Vitamin B12 deficiency Celiac disease = Malabsorption issues Chemotherapy treatment = Defect in DNA synthesis Pregnancy = Increased folate demand</p> Signup and view all the answers

Match the blood test result with its interpretation in iron deficiency anemia (IDA):

<p>Low serum iron = Indicates reduced iron availability Increased TIBC = Suggests the body is trying to compensate for low iron by increasing transferrin Decreased Hb and PCV = Indicates decreased red blood cell mass and volume Decreased MCV = Indicates smaller than normal red blood cell size</p> Signup and view all the answers

Match the condition with the type of anemia it may primarily cause:

<p>Hookworm infestation = Iron deficiency anemia Severe pancreatitis = Megaloblastic anemia Gastrectomy = Iron deficiency anemia Congenital defects in DNA synthesis = Megaloblastic anemia</p> Signup and view all the answers

Match the laboratory test value with its likely change in megaloblastic anemia compared to normal:

<p>Serum vitamin B12 = Decreased MCV = Increased Unconjugated bilirubin = Increased Platelets = Moderately reduced</p> Signup and view all the answers

Match the cause of anemia to the mechanism by which it leads to anemia:

<p>Nutritional deficiency = Lack of essential nutrients for hemoglobin synthesis. Faulty absorption = Impaired uptake of nutrients from the digestive tract Increased demand = Higher requirements for nutrients that exceed intake Excessive blood loss = Reduced overall red blood cell numbers and iron stores.</p> Signup and view all the answers

Associate the specific blood film finding with the relevant detail it reveals about the affected red blood cells:

<p>Hypochromia = Reduced hemoglobin, leading to paler color Microcytosis = Smaller than normal red blood cell size. Macrocytosis = Larger than normal red blood cell size. Ovelocytes = Oval-shaped red blood cells, common in megaloblastic anemia.</p> Signup and view all the answers

Match each clinical finding with the type of anemia where it is most commonly observed:

<p>Low hemoglobin = Both (Iron Deficiency and Megaloblastic Anemia) Pica (unusual cravings) = Iron Deficiency Anemia Neurological symptoms (e.g., paresthesia) = Megaloblastic Anemia Fatigue = Both (Iron Deficiency and Megaloblastic Anemia)</p> Signup and view all the answers

Match the treatment approach with its primary aim in managing the respective type of anemia:

<p>Iron supplementation = To increase hemoglobin levels Vitamin B12 injections = To promote DNA synthesis Folate supplementation = To address folate deficiency Blood transfusion = To rapidly increase red blood cell count</p> Signup and view all the answers

Match the laboratory finding with its specific association with iron metabolism or red blood cell status:

<p>TIBC (Total Iron Binding Capacity) = Measures the capacity of transferrin to bind iron Serum Ferritin = Indicates iron stores in the body Hemoglobin (Hb) = Measures the amount of oxygen-carrying protein in red blood cells Mean Corpuscular Volume (MCV) = Indicates the average size of red blood cells</p> Signup and view all the answers

Match the specific aspect of DNA synthesis or deficiency with the related effect in megaloblastic anemia:

<p>Impaired DNA synthesis = Leads to abnormal cell division and enlargement Vitamin B12 deficiency = Essential for DNA synthesis and cell maturation Folate deficiency = Necessary for nucleotide synthesis Hypersegmented Neutrophils = Due to delayed maturation of cells</p> Signup and view all the answers

Match the potential underlying cause of iron deficiency anemia with its direct implication:

<p>Chronic blood loss = Leads to iron depletion in the body Poor dietary intake = Insufficient iron supply from food Malabsorption syndromes = Impedes iron absorption in the digestive tract Increased demand (e.g., pregnancy) = Exceeds the body's iron storage and intake.</p> Signup and view all the answers

Match the cause of macrocytosis to the associated condition and/or disease state:

<p>Alcoholism = Direct toxic effect on bone marrow and folate metabolism. Liver disease = Abnormal lipid metabolism affecting red cell membrane Reticulocytosis = Increased number of immature red cells (which are larger), in circulation Hypothyroidism = Altered erythropoiesis (red cell formation)</p> Signup and view all the answers

Match the treatment with its role or action in anemia management

<p>Iron Supplementation = Replenishes iron stores to support hemoglobin synthesis. Vitamin B12 injections = Circumvents absorption barriers to effectively deliver necessary B12. Folate supplementation = Provides necessary building blocks for DNA production, supporting cellular growth. Manage Blood conditions (e.g. peptic ulcer) = Stops depletion of iron stores.</p> Signup and view all the answers

Match the laboratory find with its role in diagnosis of anemia.

<p>Complete Blood Count = Comprehensive snapshot of blood components and quantities. Peripheral Blood Smear = Helps evaluate morphology or red blood cell abnormalities. Serum Ferritin = Assesses overall iron stores to diagnose. Total Blood Binding Capacity = Indirect measure of transferrin (protein to transport Iron).</p> Signup and view all the answers

Associate each type of anemia with its distinct etiology and/or cause:

<p>Nutritional Deficiency (e.g. Vegetarian) = Lack/decreased amount of critical, essential ingredient needed for red cell synthesis. Malabsorption Issues (e.g. Gastric Resection) = Results in impaired Iron levels because its not absorbed in digestive system. Genetic or Congenital Deficiencies = Causes malproduction of red cells Other - Drug interactions = May affect normal, cellular growth.</p> Signup and view all the answers

Understanding clinical scenarios of anemias requires knowing that there are a variety of common symptoms. Match a common symptom from anemia to its cause.

<p>Fatigue = Lowered oxygen delivery to tissue. Headaches = Due to decreased levels of oxygen in brain. Shortness of breath = Compensatory rise in breathing rate to manage lower oxygen. Irregular heartbeats or Chest Pain = Increased in heart rate to perfuse other areas of body.</p> Signup and view all the answers

Flashcards

Iron Deficiency Anemia

Most common nutritional disorder, often half of anemia cases.

Nutritional iron deficiency

Insufficient iron intake, such as from a poor diet.

Faulty iron absorption

Conditions or surgeries impairing iron absorption like Crohn's or gastric resection.

Increased iron demand

Pregnancy or childhood growth periods need more iron.

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Iron deficiency anemia

Diagnosed by low iron stores, low hemoglobin.

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Blood Film in IDA

Microcytic, hypochromic red blood cells observed in blood film.

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Lab findings in IDA

The Hb and PCV are decreased, MCV, MCH, and MCHC are also decreased.

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Blood film IDA

Blood film shows hypochromic, microcytic red cells with anisocytosis.

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Serum Ferritin & IDA

Decreased due to measuring iron stores

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Megaloblastic anemia

Anemia due to impaired DNA synthesis in red blood cells

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Cause of Megaloblastic anemia

Typically due to vitamin B12 or folate deficiency

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Nutritional cause of Megaloblastic anemia

Low dietary Vit.B12 or folate.

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Increased demand of B12

Pregnancy, infants, and growth requirement.

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Lab diagnosis for Megaloblastic anemia

Hb and RBC count are below normal, and MCV is high (>100 FL).

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Blood film for Megaloblastic anemia

Blood film shows macrocytic with ovelocyte.

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Study Notes

Iron Deficiency Anemia

  • This is the most common nutritional disorder globally.
  • Accounts for about half of all anemia cases.
  • Diagnosis is confirmed by low iron stores and below-normal hemoglobin levels.
  • Blood film shows microcytic hypochromic cells.

Causes of Iron Deficiency Anemia

  • Nutritional deficiency: Insufficient iron intake due to poor diet or imbalanced vegetarianism.
  • Faulty or incomplete iron absorption: Occurs in conditions like achlorhydria, after gastric resection, or in Crohn's disease.
  • Increased iron demand: Seen in pregnancy and during childhood growth years.
  • Excessive blood loss: Due to hookworm, or acute and chronic hemorrhages like peptic ulcers, stomach cancer, or heavy menstruation.

Laboratory Findings in Iron Deficiency Anemia

  • Hemoglobin and PCV are decreased; red cell indices (MCV, MCH, MCHC) are also decreased.
  • Blood film examination shows hypochromic, microcytic red cells with anisocytosis.
  • Reticulocyte count is typically normal or decreased, but increases with iron treatment.
  • Platelet count is normal but may increase following acute blood loss.
  • Serum iron is low, while TIBC is high because TIBC measures transferrin.
  • Serum ferritin is decreased because serum ferritin measures iron stores.

Megaloblastic Anemia

  • Anemia resulting from inhibited DNA synthesis during red blood cell production.
  • Impaired DNA synthesis prevents cell cycle progression from the G2 growth stage to mitosis, leading to continuous cell growth without division and resulting in macrocytosis.
  • Most often caused by hypovitaminosis, specifically vitamin B12 or folate deficiency.

Causes of Megaloblastic Anemia

  • Nutritional: dietary Vitamin B12 or folate deficiency.
  • Malabsorption: can be caused by celiac disease, Crohn's disease, or gastric carcinoma.
  • Increased demand: pregnancy, infancy, and growth requirements.
  • Defects in DNA synthesis: can stem from congenital causes, acute severe pancreatitis, fish tapeworm infestation, or therapy with cytochemical drugs.

Laboratory Diagnosis of Megaloblastic Anemia

  • Hemoglobin concentration and RBC count are below normal, while MCV is high (>100 FL).
  • Blood film shows macrocytes with ovelocytes.
  • Leukocytosis and platelets are moderately reduced.
  • There is a presence of hyper-segmented neutrophils in blood film.
  • Biochemistry may show increased unconjugated bilirubin.
  • Decreased serum vitamin B12 and folate concentrations.

Causes of Macrocytosis other than Megaloblastic Anemia

  • Pernicious anemia.
  • Liver disease.
  • Reticulocytosis.
  • Alcoholism.
  • Hypothyroidism.

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