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Iron Deficiency Anemia: Signs and Symptoms

by Carlo Raj, MD

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    00:00 Continue.

    00:00 Well, obviously, the symptoms here with any type of anemia is going to be fatigue and tiredness.

    00:06 And here, with iron deficiency, weakness, pallor, tachy.

    00:11 Oftentimes, anemia, because you have decreased viscosity.

    00:14 You’ve heard what I just said, remember this from physio.

    00:17 In anemia, you don’t have as much hemoglobin concentration, so it is the opposite of polycythemia.

    00:22 Are we clear? Opposite of polycythemia.

    00:26 So we have decreased viscosity.

    00:26 Oh, what does that mean? Tachy, tachy.

    00:30 We’ll talk more about that later.

    00:31 Next, well, let’s say that your patient tells you about these issues: “Hey, doc, I’m having a hard time swallowing.” “What is it that you’re having a hard time swallowing, my friend?” “I’m having a hard time swallowing solids.” "Okay. Tell me about this. Is it getting worse?" "Are you having a hard time swallowing liquids by chance?" "No. I can have smoothie all day long, no problem." "But when I try to have that piece of chicken, that darn –" "It feels like I get a bone stuck in my throat, every single time." "Oh, okay." So, so far, we have dysphagia to solids only.

    01:10 Next, you take a look at the patient’s tongue and it’s beefy red.

    01:13 Beefy red.

    01:14 Not mine, okay? I have a lot of -- Whatever.

    01:16 So mine is not this, but if it was beefy red, then that will be glossitis, wouldn’t it? And then the patient tells you, “Hey, doc. When I’m eating ice cream, I don’t even need a spoon because my finger can do the job for me.” So this is spooning of the nails, welcome to koilonychia.

    01:33 What are all that I just give you here? I gave you webbing or a webbed type of esophagus, right? So esophageal web, number one, hence the dysphagia to solids only.

    01:47 Number two, I gave you glossitis, I gave you koilonychia and iron deficiency, no doubt, what does your patient have with those types of symptoms? Oh, very good.

    01:56 Plummer-Vinson syndrome.

    01:57 Are we clear? So chronic iron deficiency may cause pica.

    02:01 What does that mean? You’re going to start finding – Remember the body’s amazing.

    02:06 It will try to find nutrition everywhere that it can, so look for an individual that might be perhaps eating unusual things, looking for that iron, known as pica.

    02:17 Pica.

    02:20 Take a look at the nails here, they are spooned.

    02:23 This is not clubbing, be careful.

    02:25 So if you take a look at the sagittal view here on your right, the clubbing would show expansion of the nail bed, right? Or if it was bronchogenic carcinoma, you would find what’s known as clubbing-like and it’s called hypertrophic osteoarthropathy, isn’t it? This is not that.

    02:42 This is the opposite, this is spooning.

    02:44 Welcome to koilonychia and this should automatically as a high suspicion differential be something like Plummer Vinson.

    02:52 Okay.


    About the Lecture

    The lecture Iron Deficiency Anemia: Signs and Symptoms by Carlo Raj, MD is from the course Microcytic Anemia – Red Blood Cell Pathology (RBC).


    Included Quiz Questions

    1. Difficulty swallowing liquids
    2. Difficulty swallowing solids
    3. Iron deficiency
    4. Glossitis
    5. Esophageal web
    1. Koilonychia
    2. Clubbing
    3. Paronychia
    4. Hypertrophic osteoarthropathy
    5. Pica

    Author of lecture Iron Deficiency Anemia: Signs and Symptoms

     Carlo Raj, MD

    Carlo Raj, MD


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