Prescribing Safety Assessment (PSA) Practice Exam

Which of the following can lead to sideroblastic anaemia?

1. Lead poisoning

2. High altitude

3. Excessive alcohol consumption

4. Thalassaemia

The correct answer is: Lead poisoning

Sideroblastic anaemia is characterized by the body’s inability to incorporate iron into hemoglobin, leading to the formation of ringed sideroblasts in the bone marrow. One of the key causes of sideroblastic anaemia is lead poisoning. Lead interferes with several enzymatic processes involved in heme synthesis. Specifically, it inhibits the enzyme delta-aminolevulinic acid dehydratase, which is crucial in producing heme, and also affects other enzymes in the pathway, ultimately leading to the accumulation of protoporphyrin and the formation of abnormal red blood cell precursors. This disruption in heme synthesis is what causes the characteristic features of sideroblastic anaemia. On the other hand, while excessive alcohol consumption can lead to other forms of anemia and nutritional deficiencies, it is not a direct cause of sideroblastic anaemia in the same way that lead exposure is. High altitude tends to cause a different type of physiological response related to decreased oxygen levels, leading primarily to a form of secondary erythrocytosis rather than disrupting iron metabolism. Thalassaemia is a genetic disorder that affects hemoglobin production, but it doesn’t specifically cause sideroblastic anaemia as it is a separate condition related to