Best Practice Case Studies-Hematology

Pdf Summary

The provided document addresses two study questions related to iron deficiency anemia in athletes.

<strong>Study Question #1</strong> explores screening practices for iron deficiency anemia among elite athletes. The correct answer is B: "The majority of athletes who screen positive will not have obvious clinical signs or symptoms of iron deficiency anemia." It is noted that while screening for hematological and iron-related abnormalities is conducted, it yields a low number of clinically significant results. For example, a study of 576 elite athletes showed that over 50% screened positive, yet only 4.6% had clinically meaningful results. Serum iron is not considered the optimal screening test; instead, serum ferritin is more widely used, with other indices like the transferrin receptor to ferritin ratio recommended to improve diagnostic accuracy. Routine lab screenings for anemia are not recommended across all NCAA athletes, though some screenings, such as for sickle cell trait status, are mandatory, with some exceptions. 

<strong>Study Question #2</strong> considers the appearance of nails in someone with a ferritin level of 11 ng/mL, which is below the reference range. The correct response is E: "Brittle and concave shaped nails," also known as koilonychia or spoon nails, which are indicative of iron deficiency anemia. Other nail changes listed, such as hyperpigmented vertical nail bands (A), white-yellow discoloration (B), horizontal grooves known as Beau lines (C), and clubbing (D), are associated with different conditions. 

Overall, the document highlights the subtle presentation of iron deficiency anemia in athletes, the appropriate diagnostic tests to employ, and the physical signs to recognize this condition.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 24

Topic Hematology

Keywords

iron deficiency anemia

elite athletes

screening practices

serum ferritin

transferrin receptor

koilonychia

spoon nails

hematological abnormalities

sickle cell trait

diagnostic accuracy

3rd Edition

3rd Edition, CASE 24

Hematology