A 38-year-old lady presented with recurrent menorrhagia and was found to have iron deficiency anaemia. She is not a vegetarian and has no other medical illness. Treatments with iron sulphate (“FeSO4” ) 300 mg twice daily was commenced.

a) What advice (e.g. lifestyle modifications) would you recommend her regarding her FeSO4 treatment? (2 marks)

b) Discuss the adverse effects of FeSO4 (3 marks)

c) If she could not tolerate the current FESO4 therapy, list TWO approaches which may improve her tolerance to FeSO4 (2 marks)

d) Name ONE alternative form of oral iron which could be associated with better tolerance and discuss the reason for it. (2 marks)

She did not tolerate oral iron therapy and was noticed to have progressive drop in her haemoglobin with worsening symptom. She is recommended to have intravenous iron therapy.

e) List THREE parenteral iron preparations and discuss the major structural feature differentiating these products (4 marks)

f) Discuss the adverse effects of intravenous iron therapy and their management. (7 marks)