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GP CCE Caseshaematological-presentations

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.

clinical encounter with role-player (CCE format)2 min readVerification in progress

Target exams

RACGP CCEFRACGP oralsCFPC SOOs
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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

  1. Establish the diagnosis and communicate why IDA in a man is never "just low iron". [5]
  2. Deliver the mandate: coeliac serology plus bidirectional endoscopy, heightened by family history of colorectal cancer. [5]
  3. Start oral iron correctly — single morning dose, hepcidin-informed schedule — while investigation proceeds. [1]
  4. Manage resistance to colonoscopy with risk communication, not concession.
  5. Set explicit follow-up: response check at 2–3 weeks, stores repletion for three months post-normalisation. [1] [5]
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References3ShowHide
  1. [5]Goddard AF, James MW, McIntyre AS, Scott BB Guidelines for the management of iron deficiency anaemia. Gut, 2011.PMID 21561874
  2. [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
  3. [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
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