GP CCE Cases · haematological-presentations
Iron deficiency anaemia in a man — CCE clinical encounter
CCE-style clinical encounter: a 55-year-old man with Hb 98 g/L and ferritin 12 µg/L found on a workplace health check. The candidate must deliver the GI investigation mandate, coeliac screen, modern iron dosing with hepcidin logic, and manage his resistance to colonoscopy.
On this page
Study tools
Target exams
RACGP CCEFRACGP oralsCFPC SOOs
Prompt
A 55-year-old accountant attends after a workplace health screening flagged Hb 98 g/L, MCV 71 fL, ferritin 12 µg/L. He feels 'basically fine, maybe a bit tired'. He eats meat, has no bowel symptoms, no weight loss, takes omeprazole occasionally for heartburn. His father had bowel cancer at 70. He says: 'My mate reckons it's just low iron, take some tablets and get on with it.'
Objectives
- Establish the diagnosis and communicate why IDA in a man is never "just low iron". [5]
- Deliver the mandate: coeliac serology plus bidirectional endoscopy, heightened by family history of colorectal cancer. [5]
- Start oral iron correctly — single morning dose, hepcidin-informed schedule — while investigation proceeds. [1]
- Manage resistance to colonoscopy with risk communication, not concession.
- Set explicit follow-up: response check at 2–3 weeks, stores repletion for three months post-normalisation. [1] [5]
References3ShowHide
- [5]Goddard AF, James MW, McIntyre AS, Scott BB Guidelines for the management of iron deficiency anaemia. Gut, 2011.PMID 21561874
- [7]Mahadev S, Laszkowska M, Sundström J, et al. Prevalence of Celiac Disease in Patients With Iron Deficiency Anemia — A Systematic Review With Meta-analysis. Gastroenterology, 2018.PMID 29689265
- [1]Stoffel NU, Zeder C, Brittenham GM, Moretti D, Zimmermann MB Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women. Lancet Haematology, 2017.PMID 29032957