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Iron deficiency anaemia — RACP Paediatrics MCQ

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EasyHaematology and oncologyIron deficiency anaemiaRACP Paediatrics

A 20-month-old drinks more than 900 mL of cow's milk daily and has pallor and irritability. FBC shows microcytosis, low ferritin and normal inflammatory markers. What is the most likely cause?

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

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Correct answer: C — Iron deficiency from excessive cow's milk intake and low dietary iron

High cow's milk intake can displace iron-rich foods and contribute to iron deficiency anaemia in toddlers; low ferritin with microcytosis supports this. Thalassaemia major usually presents earlier with more severe anaemia and haemolysis features. The pearl is that dietary history is part of anaemia assessment, not an afterthought.

Reference: RCH Clinical Practice Guidelines: Iron deficiency; Therapeutic Guidelines (eTG); AMH Children's Dosing Companion