25 - hematopoiesis

Question 1

Anemias caused by nutrient deficiencies _ _ _

The Clinical Use of Hematopoietic Growth Factors
Erythropoietin, G-CSF, GM-CSF, and IL-11

Answer 1

iron
vitamin B12
folic acid

Sickle Cell Anemia also

Question 2

Anemia: Deficiency of _

due to deficiencies of one of three essential nutrients

Answer 2

Red Blood Cells

Iron - most common

B12
Folic acid

Question 3

is usually defined as a decrease in the amount of red blood cells(RBCs) or hemoglobin in the blood. It can also be defined as a lowered ability of the blood to carry oxygen.
When anemia comes on slowly the symptoms are often vague and may include: feeling tired, weakness, shortness of breath or a poor ability to exercise. Anemia that comes on quickly often has greater symptoms which may include: confusion,feeling like one is going to passout,andincreasedthirst.

Answer 3

Anemia

Anemia must be significant before a person becomes noticeably pale

Question 4

4- 5 grams of _in your body 65% of it is in hemoglobin 15-30% stored in hepatocytes and within the reticuloendothelial system (phagocytes, mainly macrophages) _ is the major storage protein

Answer 4

iron

Ferritin - main storage protein of iron

Question 5

Iron absorbed in _
Combines with in plasma with a protein transferrin

Excess Iron principally deposited in _ (more) and reticuloendothelial cells (phagocytes, egmacrophages; less) of the blood marrow and stored within ferritin

If iron in plasma falls low, some iron from the ferritin storage pool is removed and transported (via transferrin) to where it is needed

Answer 5

small intestine

liver hepatocytes - more

Question 6

Iron is absorbed, either as free _ ion, or as

Answer 6

free ferrous (Fe++)

hemeiron.

Question 7

_ is transported in the plasma bound to transferrin.

Answer 7

Iron

Fe3+ carried on transferrin

Question 8

Heme biosynthesis:
Mainly in the liver and bone marrow. Pathway involves mitochondrial and cytoplasmic enzymes.
Last step involves incorporation of _

Answer 8

Fe++

Question 9

Iron is called a one way element. Very little (0.5 –1.0 mg/ day) is _ through excretion each day

Answer 9

lost

regulation of homoeostasis is done at the absorption level

bleeding wil cause loss of iron from the body

Question 10

folic acid and B12 are necessary for _ synthesis. Hematopoiesis is especially sensitive (very rapid turnover rate)

Answer 10

necessary for DNA synthesis

Question 11

200 Billion per day

Cancer chemotherapy - aimed at suppressing rapidily dividing cells
_ are rapid dividing cells not intentionally killed

Answer 11

RBC

Question 12

_ are usually the first people to notice anemia patients

Answer 12

dentists

pale lining gums and loss of texture on tongue (smoothening of tongue)

Question 13

what does ferritin do

Answer 13

binds of iron and stores it

Question 14

_ iron to get into blood

once in blood binds to transferrin

Answer 14

Fe+++ to get into blood

Fe++ (free ferrous or heme iron) absorbed

Question 15

Heme

Made in _ and _

Involved mitochondrial and cytoplasmic enzymes

Last step have to convert it to or incorporate _

Answer 15

liver and bone marrow

last step - Fe++ - 2 ferrous

Question 16

Ferric - Fe 3 -

Answer 16

can now get into blood

Question 17

Ferrous - Fe 2 -

Answer 17

absorbed

Question 18

many _proteins

• Tend be involved in gas molecules or moving electrons around

Iron 2 to iron 3 and back and forth

Answer 18

HEME

Question 19

Iron levels are controlled at the level of _

Answer 19

absorption

IRON is a one way elevemt - gets in and stays there
Doesn’t excrete thru urine

Question 20

TX for iron deficiency anemia

Answer 20

oral or parenteral iron supplement

Question 21

_ and _ deficiency need more DNA metabolism

Answer 21

Folic acid (DNA synthesis, growing cells need this)

and B12 (important in myelination process) anemias

Question 22

_ anemia - reflects an absorption problem

Need protein INTRINSIC FACTOR to absorb

Answer 22

B12 (Cobalamine)

intrinsic factor - gylcoprotein

combine with B12 forming complex that resist digestion by GIT enzymes in stomach

Question 23

deicicency of _ causes

macrocytic anemia due to failure of maturation of RBC

and neurological manifestations because it is needed for myelination of nerves

Answer 23

vitamin B12

Question 24

why doesn’t oral admin of B12 for B12 anemia patients work

Answer 24

B12 anemia - lacking intrsnic factor = leads to production of GASTRIC ACID

Doesn’t really do anything taken orally because missing intrnsic factor - need to be injected
because prob due to missing of intrisinc factor - so doesn’t form that complex

need parenteral

Question 25

macrocytic anemia

megaloblastic anemias - presence of large RBC’s

caused by?

Answer 25

defective DNA syntheisis

Cobalamin (B12 deficiency) - pernicisous anemia = most comon cause

and folic acid deficinecy - poor nutrition - anorexia, malabsorb, ETOH, hemodialysis

Question 26

how is sickle-cell disease considered an anemia

Answer 26

Hemolysis of RBC’sis the actual cause of the illness

Sickled cells only last 10-20 days

Question 27

how to tx sickle cell anemia

Answer 27

bone marrow(stem cell) transplant

need donor - 85 success = risky

only done in severe cases

Question 28

_ a glycoprotein that is produced in the kidney controls erythropoiesis - stimulates RBC proliferation
Given to cancer chemotherapy patients

Answer 28

Erythropoietin

senses
and responds to low oxygen or hypoxia

Question 29

G-CSF, GM-CSF are used to tx chemotherapy induced _

Answer 29

neutropenia - low PMN count

G-CSF glycoprotein that stims marrow to produce granuloytes and stem cells and release them

GM-CSF - monomeric glycoprotein secreted by macrophages, T cells, Mast cells endothelial cells and fibroblasts that fxn as cytokin e

Question 30

IL-_ has been demonstrated to improve platelet recovery after chemoinduced thrombocytopenia (loss of platelets)

Answer 30

IL-11