Curriculum standards
Knowledge guides
LG15: Anaemia and iron disorders
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.
Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.
Presentations
- Cardiovascular symptoms,
such as:
- hypotension
- tachycardia
- Fatigue
- Haematological disorders in pregnancy
- Iron deficiency and overload
- Symptomatic anaemia
Conditions
- Anaemia due to:
- acquired primary marrow
causes:
- acquired pure red cell aplasia
- myelodysplastic neoplasms
- congenital primary marrow
causes:
- congenital dyserythropoietic anaemia
- enzymopathies
- glucose-6-phosphate dehydrogenase (G6PD)
- haemoglobinopathies:
- hereditary persistence of fetal haemoglobin
- sickle cell anaemia
- thalassemia
- unstable haemoglobins
- pyruvate kinase deficiencies
- red cell membrane
disorders:
- hereditary elliptocytosis
- hereditary spherocytosis
- deficiencies, such as:
- B12
- folate
- iron:
- with anaemia
- without anaemia
- haemolysis:
- autoimmune haemolytic anaemia
- cold agglutinin disease
- infection-related
- mechanical
- metabolic enzyme deficiencies
- microangiopathic haemolytic anaemias
- red cell membrane disorders
- pregnancy, including:
- iron deficiency
- pathological
- physiological
- acquired primary marrow
causes:
- Haemochromatosis and iron overload disorders
- Non-haematological chronic diseases:
- chronic inflammation
- infectious diseases, such as:
- cytomegalovirus (CMV)
- Epstein–Barr virus
- human immunodeficiency virus (HIV)
- malaria
- kidney impairment
- liver disease
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Confusion
- Critical care / Acutely unwell patients
- Haemorrhage
- Hypoxia
- Neurological symptoms
- Sepsis
Conditions
- Anaemia associated with medical
conditions:
- chronic kidney disease
- copper deficiency
- endocrine disorders
- heart failure
- HIV infection
- immunosuppression therapy
- liver disease
- malignancy
- malnutrition
- Porphyrias
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Anticoagulants for procedures
- Erythropoiesis, including the role of erythropoietin and the ontogeny of red cell precursors
- Ethnic and geographic distribution and prevalence of haemoglobinopathies and thalassaemia
- Haemoglobin function and structure
- Iron metabolism, and causes of iron overload and deficiency
- Pathophysiology of anaemia and its causes:
- accelerated destruction
- bleeding
- ineffective erythropoiesis
- nutritional deficiencies
- Assays of haematinic factors, such as:
- B12
- folate
- iron studies
- Bone marrow examination
- Investigative techniques:
- clinical, including family studies
- C-reactive protein (CRP) test
- full blood count
- investigation and result evaluation
- iron studies
- laboratory
- radiological
- Laboratory diagnosis of abnormal haemoglobins
- Supportive treatments, such as erythropoietin supplementation,
haematinic supplements, and transfusions:
- chelation therapy
- hyperferritinaemia versus iron overload
- investigating and managing iron overload
- therapeutic venesection
- Genetic basis of haemoglobinopathies, red cell membrane, and enzymopathies, and implications for family planning