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Iron deficiency anaemia biochemistry — MRCPCH TAS MCQ

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EasyNutrition and metabolismIron deficiency anaemia biochemistryMRCPCH TAS

A toddler drinking large volumes of cow's milk has pallor and pica. Bloods show microcytosis, low ferritin and high total iron-binding capacity. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Iron deficiency anaemia

Low ferritin with microcytosis is most consistent with iron deficiency anaemia. Beta-thalassaemia trait can cause microcytosis but ferritin would not be low because iron stores are preserved. The pearl is that excessive cow's milk intake can displace dietary iron in toddlers.

Reference: Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi; Lissauer's Illustrated Textbook of Paediatrics