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Hematology > 10.10.18 Iron Deficiency > Flashcards

10.10.18 Iron Deficiency Flashcards

1
Q

How is heme iron absorbed?

How is non-heme iron absorbed?

A

Heme- meat

Nonheme- stomach acid and other substances that impede/absorb iron

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2
Q

Dietary iron is reduced to ferrous state by this enzyme

A

DcytB- ferric reductase

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3
Q

Ferrous iron is then transported into the enterocyte by this transporter

A

DMT1

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4
Q

Iron leaves the enterocyte and enters circulation by this protein facilitated by haphaestin

A

Ferroportin

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5
Q

Where else does ferroportin release iron from other than the enterocyte?

A

Hepatocyte and macrophages

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6
Q

What blocks the action of ferroportin and lowers serum iron concentration

A

Hepcidin

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7
Q

binds to iron in the bloodstream and transports it to cells

A

Transferrin

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8
Q

This goes up when the body is iron deficient

This level falls as body becomes iron deficient

A

TIBC

Ferritin

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9
Q

fraction of available iron binding sites which have iron bound to them. This falls as body becomes iron deficient.

A

Transferrin saturation

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10
Q

How does iron leave the body?

A

When cells are lost

  1. Menstruation
  2. Pregnancy
  3. Blood donation
  4. GI blood loss
  5. GU loss
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11
Q

What are good sources of iron

A

Liver, Oysters, Clams

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12
Q

What is iron deficiency in adults almost always due to?

What are other components that can contribute to iron deficiency?

A

Blood loss

Malabsorption or dietary insufficiency

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13
Q

What will the body in early iron deficiency use before dropping the hemoglobin

As iron deficiency becomes more profound what will occur?

A

Iron stores

Anemia

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14
Q

What are the main clinical presentation of iron deficiency?

A
  1. Pica

2. Thrombocytosis- elevated platelet count

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15
Q

Spooning of the nails

A

Koilonychia

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16
Q

Obsessive consumption of substances with no nutritional value, such as ice, starch, dirt, or paper

A

Pica

17
Q

What are the lab values that show iron deficiency?

A
  1. Elevated RDW
  2. Falling MCV
  3. Serum Iron falls
  4. TIBC increases
  5. Transferrin saturation falls
  6. Ferritin low
18
Q

What is the single best best test for iron deficiency and what is the gold standard for evaluation?

A

Test- Ferritin

Gold standard- bone marrow evaluation

19
Q

What is blood like during the last trimester?

What happens after birth (physiologic anemia of infancy)

A

RBC mass and production increases, iron stores laid down, Hb high

Hb and reticulocyte drops; preemies have lower Hb nadir than term infants

20
Q

What happens to blood during puberty

A

Rises more for males than females

Males need more myoglobin for muscle and women begin menstruation

21
Q

What are risk factors for iron deficiency in children?

A

Perinatal risk factors (maternal iron levels) and dietary risk factor (cows milk)

22
Q

How do you prevent iron deficiency in children?

A
  1. Treat iron deficiency and pregnant and lactating women
  2. Use iron-fortified formulas
  3. Avoid cow’s milk until 1 year
  4. Children 1 to 5 should consume no more than 600 mL of milk per day
23
Q

What are the consequences of iron deficiency in children?

A
  1. Neuropsychiatric manifestations
  2. Increased risk of thrombosis in infants
  3. Increased risk of lead toxicity
24
Q

What are global health strategies for iron deficiency?

A
  1. Iron supplementation
  2. Fortification
  3. Antihelminthic therapy (deworming)
25
Q

What are the global health downsides to iron supplementation?

A
  1. Can increase susceptibility to malaria (parasite can’t infect iron deficient cells)
  2. Iron overload in areas of severe thalassemias that increase iron absorption
26
Q

In this type of anemia, cytokines act to sequester iron away from the bloodstream by increasing levels of hepcidin thus allowing serum iron levels and TIBC to fall

A

Anemia of Chronic Disease

Hematology (23 decks)

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