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Q1: Definition and epidemiology (2 min)
- Define anaemia of chronic disease and give its alternative name (anaemia of inflammation).
- Where does it rank among anaemias? (second commonest worldwide after iron deficiency; commonest in hospitalised patients).
Q2: Pathophysiology (3 min)
- Explain the role of hepcidin and the cytokine that induces it (IL-6 via JAK-STAT3).
- How does hepcidin act on ferroportin, and what is the consequence for iron handling (functional iron deficiency)?
- Name two further mechanisms: suppressed erythropoiesis and a shortened red-cell lifespan.
Q3: Diagnosis and iron studies (3 min)
- Describe the typical full blood count (normocytic normochromic, occasionally mild microcytic; low reticulocytes).
- Contrast the iron-study profile of anaemia of chronic disease versus iron deficiency anaemia.
- Why can a 'normal' ferritin be misleading in an inflamed patient? (acute-phase reactant; use soluble transferrin receptor if uncertain).
Q4: Management (2 min)
- What is the cornerstone of management? (treat the underlying cause).
- When is oral iron inadequate, and what is preferred? (hepcidin blocks absorption; IV iron for active inflammation or coexisting deficiency).
- In which patients are erythropoiesis-stimulating agents used, and what Hb is targeted? (CKD, chemotherapy-induced anaemia; target around 100 to 115 g/L).