Iron Deficiency Anemia: Definition, Pathogenesis, Etiology, Symptoms, Treatment and MCQs for NEET, GPAT, CSIR NET JRF
“Iron deficiency anemia is a common type of anemia in which blood lacks sufficient amount of red blood cell to carry out the oxygen and is occurred due to the deficiency of iron as the name implies.”
PATHOGENESIS: –
Iron deficiency anemia develop when the supply of iron is inadequate for the requirement of hemoglobin synthesis. To maintain the hemoglobin synthesis due to the negative iron balance is covered by the mobilization of the tissue stores.
The development of iron deficiency depends upon one or more of the following factors:
- Increased blood loss
- Increased requirement
- Inadequate dietary intake
- Decreased intestinal absorption
The relative significance of these factors varies with the age and sex of the patient. In poor or developing countries insufficient intake of iron or defective absorption are responsible for the iron deficiency anemia.
ETIOLOGY: –
A.] Increased blood loss
- Excessive menstruation in reproductive years, repeated miscarriages, at onset of menarche, post-menopausal uterine bleeding.
- Gastrointestinal problems like peptic ulcer, hemorrhoids, cancer of stomach, large bowel etc.
- Hemoptysis
- Repeated epistaxis from nose
B.] Increased Requirement
- Spurts of growth in infancy, childhood and adolescence
- Prematurity
- Pregnancy and lactation
C.] Inadequate dietary intake
- Poor economic status
- Anorexia e.g., in pregnancy
- Elderly individuals due to poor dentition, apathy and financial constraints
D.] Decreased absorption
- Partial or total gastrectomy
- Achlorhydria
- Intestinal malabsobtion such as in coeliac disease
SYMPTOMS: –
Following are the symptoms of Iron deficiency anemia:
- Dizziness
- Fatigue
- Lethargy
- Light-headedness
- Malaise
- Brittle nails
- Hair loss
- Headache due to low oxygen
- Irritability
- Shortness of breath
- Restless legs syndrome
TREATMENT: –
Following are the treatment given to the Iron deficiency anemia patient:
1.] Oral iron therapy with soluble ferrous iron salts, which are not enteric coated and
not slow- or sustained-release, is recommended at a daily dosage of 200 mg elemental
iron in two or three divided doses.
2.] Iron is poorly absorbed from vegetables, grain products, dairy products, and eggs,
and best absorbed from meat, fish, and poultry. Administer iron at least 1 hour before
meals because food interferes with absorption, but administration with food may be
needed to improve tolerability.
3.] Consider parenteral iron for patients with iron malabsorption, intolerance of oral
iron therapy, or noncompliance. Parenteral administration, however, does not hasten
the onset of hematologic response. The replacement dose depends on the etiology of
anemia and Hb concentration.
4.] Iron dextran, sodium ferric gluconate, ferumoxytol, and iron sucrose are available
parenteral iron preparations with similar efficacy but different molecular size, pharmacokinetics,
bioavailability, and adverse effect profiles.
MULTIPLE CHOICE QUESTION: –
1.] Anemia which is caused due to the deficiency of iron is called?
a. Iron deficiency anemia
b. Folic deficiency anemia
c. Aplastic anemia
d. None of the above
2.] Iron deficiency anemia is caused due to the deficiency of which element?
a. Mercury
b. Iron
c. Carbon
d. None of the above
3.] Iron deficiency anemia is the most common type of anemia.
a. True
b. False
4.] Anemia is of particular concern in?
a. Young children
b. Pregnant women
c. Older individuals
d. All of the above
5.] Iron deficiency anemia is common in adolescent with?
a. Asthma
b. Bulimia
c. Heavy menstrual bleeding
d. Obesity
6.] Unexplained IDA may be linked to?
a. Celiac disease
b. Crohn’s disease
c. Diverticulitis
d. None of the above
7.] Anemia affects what percentage of the population?
a. 12%
b. 18%
c. 27%
d. 32%
8.] What is the most common of IDA in elderly?
a. Malnutrition
b. Chronic kidney disease
c. Medication side effect
d. Gastrointestinal blood loss
9.] Which of the following are the symptoms of Iron deficiency anemia?
a. Fatigue
b. Malaise
c. Headache due to low oxygen
d. All of the above
10.] The development of iron deficiency depends upon which of the following factors?
a. Increased blood loss
b. Inadequate dietary intake
c. Both (a) and (b)
d. None of the above
SOLUTION: –
1.] (a) Iron deficiency anemia
2.] (b) Iron
3.] (a)
4.] (d)
5.] (c) Heavy menstrual bleeding
6.] (a) Celiac disease
7.] (c) 27%
8.] (c) Medication side effect
9.] (d)
10.] (c)
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REFERENCES: –
1.] Textbook of Pathology by Harsh Mohan; 7th edition; Page no.272 – 277.
2.] Robbin’s Basic Pathology; 5th edition; Page no.610 – 613.