Iron deficiency anaemia — MRCPCH FOP MCQ

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ModerateHaematology and oncologyIron deficiency anaemiaMRCPCH FOP

A 2-year-old boy drinks 1.2 litres of cow's milk daily and is pale. Blood tests show Hb 82 g/L, MCV 62 fL, low ferritin and normal white cell and platelet counts. What is the most likely diagnosis?

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Correct answer: B — Iron deficiency anaemia

Microcytic anaemia with low ferritin and excessive cow's milk intake is typical of iron deficiency anaemia. Thalassaemia should be considered in microcytosis but ferritin would not be low from thalassaemia itself. Leukaemia would often have additional cytopenias, blasts, bruising or systemic features. The pearl is that dietary milk excess can displace iron-rich foods in toddlers.

Reference: NICE CKS Anaemia iron deficiency; BNFc iron salts