Clinical haematology · UKMLA & AKT

Iron deficiency anaemia

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise iron deficiency anaemia — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • FBC - low Hb, low MCV (<80 fL), low MCH; microcytic anaemia
  • Serum ferritin - low (<15 mcg/L) is highly specific for IDA; beware false-normal in infection, inflammation, liver disease, malignancy (ferritin is an acute phase reactant)
  • Reticulocyte count - normal or low in IDA; elevated in haemolytic anaemia
  • Coeliac serology (tTG-IgA) - check routinely in unexplained IDA
  • OGD and colonoscopy - all men and postmenopausal women with unexplained IDA to exclude GI malignancy
  • Haemoglobin electrophoresis - if thalassaemia suspected (disproportionate microcytosis with normal iron studies)

Thalassaemia trait: MCV disproportionately low (often <70 fL) relative to only mild anaemia (Hb rarely <90 g/L), with normal iron studies. Do not label this as IDA - confirm with haemoglobin electrophoresis.

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