7739808
Description
Flashcards by Ashutosh Kumar, updated more than 1 year ago
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Created by Ashutosh Kumar
almost 8 years ago
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| Question | Answer |
| 3 common scenarios of iron deficiency: | 3 common scenarios of iron deficiency: Children being bottle fed as the sole source of nutrition too long. Menstruation. Bowel cancer. |
| Differentials for microcytic anaemia: | Differentials for microcytic anaemia: Iron deficiency anaemia (not a diagnosis; what is causing this?) Anaemia of chronic disease. Thalassemia. |
| Women with iron deficiency anaemia: | Women with iron deficiency anaemia: If a woman exhibits iron deficiency anaemia, then this makes it 4x more likely that she has coeliac disease. Also important to note whether she is pre or postmenopausal. |
| Ferritin: Indicator of iron status: Causes of high ferritin: | Ferritin: Ferritin is the main indicator of iron status. Ferritin is not a reliable indicator of iron status in inflammation. This is because in an inflammatory state, macrophages sequester iron and release ferritin. In addition, transferrin decreases. If the ferritin is greater than 100 ug/L in the presence of inflammation then unlikely to be iron deficient. In the presence of liver damage the ferritin can be very high and the iron status cannot be assessed. Causes of high ferritin: Infection/inflammation. Liver damage (non-specific). Haemochromatosis. Some chronic anaemias (especially folate/B12 and myelodysplasia). Chronic transfusions. |
| Reasons for transferrin elevation: | Transferrin: Transferrin can be elevated due to an increase in oestrogen; causes include pregnancy and COCP. |
| DDx for inflammation: Malignancy DDx: | DDx for inflammation: Infection. Autoimmune. Malignancy. Malignancy DDx: Hodgkin’s lymphoma. Renal cell carcinoma. Ovarian cancer. Colorectal cancer. |
| Haemochromatosis: Presentation: Pathophysiology: Prevalence: Mimicked by: | Haemochromatosis: Presents with arthritis in MCP joints. Macrocytosis, high ferritin and transferrin saturation. Circulating iron: Too much iron in the blood (high transferrin saturation) causes fatigue and arthritis. Storage iron: Too much iron stored in tissues (high ferritin) causes liver damage (only if ferritin>1000). Haemochromatosis is very common (recessive condition, 14% carriers). Haemochromatosis can be mimicked by folate and/or B12 deficiency causing macrocytosis. |
| Myelodysplastic syndrome pathophysiology with regards to anaemia: | Myelodysplastic syndrome: Causes chronic anaemia and the high erythropoietic drive causes high iron absorption and stores. Chronic transfusions can further increase ferritin. |
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