IDA Jeopardy

IDA

100

can cause irritation or even microscopic bleeding in the digestive tract, leading to iron loss

cow's milk

200

The American Academy of Pediatrics (AAP) recommends limiting cow's milk intake to what daily amount?

16 oz/day

300

high protein intake from CM may also place infants at increased risk of what in later childhood

obesity

400

Taking iron supplements with what beverage can help with iron absorption in children? 

OJ or any Vit C containing juice

500

the 2 component in cow's milk that can inhibit the absorption of iron from food and supplements.

calcium and caseine

Iron FYI

100

3 symptoms of iron deficiency that can be found on a PE of a toddler: 

1. Pale skin and oral mucosa
2. irritability
3. fatigue
4. tachycardia
5. painful or swollen tongue.
6. Enlarged spleen

200

Iron dose recommendations for preventions of IDA in children? 

• 1-2mg/kg/day is the preventative dose for iron deficiency

300

Range of iron supplementation dosing for IDA in children is: 

3-6mg/kg/day is the recommended dose for treatment of iron deficiency and IDA Higher doses should be considered in those children with severe anaemia

400

What is the most useful screening to assess iron stores in a child? 

Serum ferritin is the most useful screening test for assessing iron stores;  reduced serum ferritin (<20 μg/L) indicates borderline/low iron stores, a retic count and CBC are typically rechecked after 6-8 weeks of iron supplements

500

Once starting iron supplements, how long should a PCP wait to recheck levels and what labs should be ordered 

8-12 weeks and hbg and serum ferritin levels

FYI

100

complication of iron deficiency: wanting to eat odd substances, such as dirt or ice

PICA

200

3 Long term effects of IDA on children: 

long-term developmental issues, particularly affecting cognitive and motor skills, as well as behavioral problems like inattentiveness and hyperactivity

300

Alternative formulations of iron supplements used in pediatrics that may be more palatable: 

Celebrate: chewable tabs, better taste,contains VitaminC 

•Novaferrum:better tasting liquid.Gentle on the stomach.

 •Iron Gummies: palatable, low iron content so ensure adequate dosing 

•Proferrin:l ess GI upset, improved correction of iron deficiency. *Most are available over the counter, dose based on elemental iron.

400

Hemaglobinopthies that may be causing inadequate responses to iron supplementation

• Thalassemia: Hemoglobin electrophoresis is crucial to rule out beta-thalassemia trait or other variants, but iron deficiency can falsely lower HbA2 levels, so iron repletion should precede testing if beta-thalassemia is suspected. 
  
  
• Sickle Cell Trait: While generally benign, sickle cell trait can affect iron metabolism and response to supplementation. 

500

2 Common causes of inadequate response to iron supplementation in children

Vit B or folate deficiencies

Poor compliance

low gastric ph

Iron refractory IDA (rare genetic condition)

Hemaglobinopathies

Ongoing source of bleeding not identified

Malabsorption issues