Iron Deficiency Post-Module Assessment Assessment Question Title * 1. Please select your specialty program Internal Medicine Hematology Gastroenterology Nephrology Emergency Medicine Family Medicine Obstetrics and Gynecology Medical Student Other (please specify) Question Title * 2. Please select your training level Medical student PGY 1 PGY 2 PGY 3 PGY 4 PGY 5 Fellow Other (please specify) Question Title * 3. Which of the following decreases the absorption of iron? a) Proton pump inhibitors b) Polyphenols c) Calcium d) All of the above Question Title * 4. Which of the following acts as the transporter of iron? a) Ferritin b) Hepcidin c) Transferrin d) Ferroportin Question Title * 5. Which of the following are states of high iron demand? a) Pregnancy b) Lactation c) Use of erythropoiesis stimulating agents, e.g. Darbepoetin d) All the above Question Title * 6. Which of the following is true? a) Functional iron deficiency is characterized by low iron stores b) Hemoglobin may be normal in early stages of iron deficiency c) Hepcidin levels are high in absolute iron deficiency, but low in functional iron deficiency d) All the above Question Title * 7. All the following are associated with functional iron deficiency, except: a) Heart failure b) Heavy menstrual bleeding c) Inflammatory bowel disease d) Chronic kidney disease Question Title * 8. Which of the following statements is true? a) Iron has no roles other than production of hemoglobin b) Iron deficiency without anemia is associated with negative consequences c) Iron deficiency without anemia does not require iron repletion therapy d) All the above Question Title * 9. Which of the following can be expected in isolated functional iron deficiency? a) Ferritin low, transferrin saturation (TSAT) low, total iron binding capacity (TIBC) low, serum iron low b) Ferritin low, TSAT high, TIBC high, serum iron low c) Ferritin high, TSAT low, TIBC low, serum iron low d) Ferritin high, TSAT high, TIBC high, serum iron low Question Title * 10. Which of the following is the most common cause of iron deficiency in adults in high-resource countries? a) Decreased dietary intake b) Celiac Disease c) Bleeding d) Helicobacter Pylori (H. Pylori) infection Question Title * 11. Which of the following causes iron deficiency? a) Regular Dialysis b) Chronic Intravascular Hemolysis c) High intensity exercise d) All the above Question Title * 12. All the following are clinical features of iron deficiency, except: a) Restless leg syndrome b) Resting tremor c) Depression d) Hair loss Question Title * 13. True or false: Iron profile (serum iron, total iron binding capacity, and transferrin saturation) testing should be performed after fasting overnight. True False Question Title * 14. Which of the following may be seen in iron deficiency anemia? a) Hypersegmented neutrophils b) Low reticulocyte count c) Low platelets d) Decrease in the soluble transferrin receptor Question Title * 15. Which of the following may be a part of the work-up of iron deficiency? a) Detailed menstrual history b) H.Pylori testing c) Upper and lower GI endoscopy d) All the above Question Title * 16. The earliest response during treatment of iron deficiency anemia with oral iron supplementation is an increase in: a) Hemoglobin b) Ferritin c) Reticulocyte count d) Mean Corpuscular Volume (MCV) Question Title * 17. Which of the following is an indication to use parenteral iron therapy as first line for treatment of iron deficiency anemia? a) Third trimester of pregnancy b) Congestive heart failure with NYHA class II/III symptoms c) Active inflammatory bowel disease d) All the above Question Title * 18. All the following statements are true, except: a) Iron sucrose (Venofer ®) may be prescribed by any physician b) Parenteral iron is generally not associated with gastrointestinal side effects c) Iron sucrose (Venofer ®) is covered by Ontario Drug Benefit Program via the exceptional access program d) IV iron therapy can only be provided to patients admitted in a hospital Question Title * 19. All the following are advantages of parenteral iron compared to oral iron, except: a) More rapid correction of anemia and symptom improvement b) Able to administer large doses (e.g. 1000mg elemental iron) in a single infusion c) Is generally not associated with gastrointestinal side effects d) Parenteral iron is universally covered by provincial drug programs Question Title * 20. Which of the following statements is true regarding maintenance iron therapy? a) It is suggested to recheck the complete blood count and ferritin after approximately 3 months of starting treatment b) Therapy targets include maintaining a normal Hb level, Ferritin >50mcg/L, and resolving symptoms related to iron deficiency c) Only oral iron therapy can be used for ongoing therapy d) A) and B) e) B) and C) Question Title * 21. Which of the following is true regarding adverse reactions of parenteral iron? a) The frequency of anaphylactic reactions is less than 1 in 200,000 b) Red blood cell transfusions have higher incidence of anaphylaxis compared to parenteral iron c) The most frequent adverse reactions are hypersensitivity, fishbane reaction (transient flushing, chest tightness, and myalgia due to cytokine release), and skin staining d) All the above Question Title * 22. In patients with heart failure, which of the following is true? a) Iron deficiency is associated with more advanced heart failure and mortality b) A ferritin >100mcg/L with TSAT <20% excludes the diagnosis of iron deficiency c) Iron repletion is associated with improved exercise tolerance d) A) and C) e) B) and C) Question Title * 23. Anemia in the preoperative setting is associated with increased risk of: a) Length of hospital stay b) Requirement of red blood cell transfusion c) Mortality d) All the above Question Title * 24. Which of the following statements is true in patients with chronic kidney disease: a) Parenteral iron should only be used in patients requiring hemodialysis b) Chronic kidney disease and dialysis increase the risk of functional iron deficiency c) Iron replacement therapy should not be used with erythropoiesis stimulating agents d) A) and B) e) A) and C) Question Title * 25. I feel comfortable about my understanding of the pathophysiology of iron deficiency a) Strongly agree b) Agree c) Neither agree nor disagree d) Disagree e) Strongly disagree Question Title * 26. I feel comfortable diagnosing iron deficiency a) Strongly agree b) Agree c) Neither agree nor disagree d) Disagree e) Strongly disagree Question Title * 27. I feel comfortable in my knowledge of the indications for parenteral iron therapy a) Strongly agree b) Agree c) Neither agree nor disagree d) Disagree e) Strongly disagree Done