Medically Fit For Exams
Medically Fit For Exams

Anaemia history taking

​This station is likely to be combined with interpretation of results, with history taking being an investigation of the cause of anaemia. This is the assumption made here.


  • Introduce yourself and wash hands
  • Check the patient's name and DOB
  • Gain consent to talk to the patient


  • Ask if the patient discussed any cause for anaemia with the doctor when they ordered the blood test
  • Re-explore this issue
  • Ask about other causes of iron deficiency anaemia, include:
    • Menstrual loss
      • Ask if the patient is having periods
      • Ask how heavy they are
      • Ask how many days in a month they are bleeding for
      • Ask if the patient is pregnant
    • GI bleed
      • Change in bowel habits
      • Change in stool consistency
      • Blood in the stool?
        • Outside of stool?
        • On paper?
        • Mixed in?
        • Black, tarry stool? (Melena)
      • Weight loss
      • Fatigue
      • Drug history
        • NSAIDs (GI bleed)
        • Anticoagulants (general bleeding risk)
    • Insufficient intake
      • Ask what the patient’s diet is like
      • Meat?
      • Green veg?
      • Pulses?
    • Malabsorption
      • Coeliac
        • Problems with gluten
        • Family history
        • Pain/diarrhoea after eating (gluten)
      • IBD
        • Watery diarrhoea
        • Weight loss
        • Blood in stool
        • Nausea
  • Recent travel
    • Parasitic infection eg hookworm
  • Recent trauma/blood loss/blood donation
  • Ask about symptoms of anaemia
    • Chest pain
    • Palpitations
    • SOB on exertion
    • Fatigue
    • Claudication on exertion

NEXT STEPS if clear + non-suspicious cause identified

No further investigation required (eg intake, menstruation, blood donation, pregnancy)

Oral iron supplements

Book review in 4 to 6 weeks









NEXT STEPS if suspicious cause suspected

Refer for endoscopy and gastroscopy

Urine dip for haematuria (renal carcinoma in 1% of iron deficient)

Coeliac screen (up to 4% pre-menopausal women

Oral iron supplementation to replenish stores, while identifying cause

Consider H. pylori testing if resistant to supplementation (reduces absorption)










Anaemia of chronic disease history taking – beware and re-check if you think the blood results suggest this, as this is a very difficult history to take in the time available

  • Ask if the patient has any medical problems that they see the doctor or hospital about
  • Ask if the patient has noticed any physical changes or symptoms recently
  • Take history as indicated from the patient’s response
  • Possible causes relate to inflammation and include:
    • Rheumatoid Arthritis
    • IBD
    • SLE
    • Vasculitis
    • Sarcoidosis
    • Chronic infections
    • Cancer
    • CKD
Anaemia blood interpretation and history[...]
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