A. Iron deficiency – Explanation

• Fe ↓
• Ferritin ↓
• TIBC t

Thalassamia

• Normal iron studies
• Electrophoresis to see type
• Anaemia of chronic disease
• Fe ↓
• Ferritin t
• TIBC ↓

Sideroblastic anaemia

• Fe t
• Ferritin t
• In sideroblastic anaemia, the body has iron
  available but cannot incorporate it into
  haemoglobin

• Hypersegmented neutrophils

B12 deficiency

• Neurological problems
• Subacute combined degeneration of the cord
• Serum B12 ↓

Folate deficiency

• Serum folate ↓

Normoblastic (Non-megaloblastic

• Alcohol
• Liver disease
• Hypothyroidism
• Pregnancy
• Reticulocytosis
• Myelodysplasia
• Drugs: cytotoxics

• Haemolytic anaemias: Bloods in general show t LDH, t unconjugated bilirubin,
  ↓haptoglobin, t reticulocytes

• Blood smear → Sickle cells
• Sickle solubility test → This test detects the presence of haemoglobin S but does not distinguish
  between sickle cell disease and trait
• Hb electrophoresis → For asymptomatic patients to see if patient has trait
• Treatment: Acute → IV fluids, morphine, O2, antibiotics
• Prophylaxis → Hydroxyurea. Also needs pneumococcal vaccines

Autoimmunehaemolysis

• COOMBS test
• Treat with steroids

Hereditary spherocytosis

• Blood film → spherocytes
• Osmotic fragility test

• Treatment:Splenectomy

G6PD deficiency

• Blood film → Heinz bodies
• Check G6PD levels
• Treatment: stop offending drugs