This edition of FP Essentials focuses on anemia, a global health problem with multiple causes and significant health impacts. Section One covers the evaluation of patients with suspected anemia, and includes definitions, diagnostic strategies, and an overview of common causes. Section Two addresses microcytic anemias, including iron deficiency anemia (the most common cause of anemia), thalassemia, sideroblastic anemia, and others. In a change from prior practice, oral iron replacement has been shown to be more effective and have fewer adverse effects if administered once daily or once every other day. Intravenous iron replacement is increasingly used, particularly for patients with chronic heart failure or those who have severe anemia associated with pregnancy. Section Three addresses the macrocytic anemias, the most prominent of which is megaloblastic anemia due to vitamin B12 deficiency. It was helpful to be reminded that when a patient has both vitamin B12 and folate deficiencies, the vitamin B12 must be replaced first, preferably using injectable vitamin B12, to avoid progression of neurologic complications. Section Four covers the diagnosis and management of normocytic anemia, including anemia of inflammation, the hemolytic anemias, anemia of chronic kidney disease, acute blood loss anemia, and others. I hope you find the information in this edition of FP Essentials useful in your practice.
When you have finished studying these four sections and are ready to submit your posttest answers, please take a moment to tell us what was most useful and what we can do to improve. We look forward to hearing your ideas for topics you would like to see covered in future editions.
Karl T. Rew, MD, Associate Medical Editor
Associate Professor, Departments of Family Medicine and Urology
University of Michigan Medical School, Ann Arbor