anaemias Flashcards
microcytic anaemias acronym
Thalassaemia
Anaemia of chronic disease
Iron deficiency
Lead poisoning
Sideroblastic
what are the two subsets of microcytic anaemia
haem problem or globin problem
IDA is what sort of anaemia
microcytic
globin problem is
thalassaemia
where iron absorved
duodenum and upper jejunum
how is iron excreted
it isn’t
iron absorbed best in… environment
acidic
what is DMT1
divalent metal transferase
- absorbs iron into enterocyte
what stops iron from leaving enterocytes
hepcidin (blocks ferroportin)
where does most iron go
bone marrow
EPO 2 jobs
increase maturation of erythroblasts
increased proerythroblast formation
RBC glut transporter
1
who recycles iron in spleen
macrophages
how does iron get out of macrophages
ferroportin
hepcidin goes up in..
inflammation
why are end-stage kidney pts anaemic
no EPO made
haemolytic anaemia
too much bilirubin in blood - jaundice
aniscytosis
varying size RBC on smear
how many irons on one transferrin
2
which IL increses hipcidin production in th eliver
IL6
IDA and inflammation which test
serum transferrin saturation
macrocytic aneamia causes
B12 and folate deficiency
folate is converted to.. in the…by
tertrahydrofolate in the gut dihydrofolate reductase
folate is used to
transfer carbon eg methyl groups
liver store of folate
3-4 months
drug which impairs dihydrofolate
methotrexate
hypersegmented nucleus of neutrophil, large RBC
megaloblastic anaemia
B 12 is for
methianine synthase
methyl malonyl co-A mutase
methyl malonyl co-A mutase deficiency
myelination prob
megalobastic anaemia plus neurologic symptoms
B12 deficiency
folate deficiency neurological symptoms in adults?
no
where is B12 stored? How long?`
liver 3-6 years
NOS abuse leads to
B12 deficiency - neurological damage
most specific test for pernicious anaemia
anti IF antibodies
what does methyl malonyl mutase enzyme do
Methylmalonyl-CoA mutase catalyzes the conversion of L-methylmalonyl-CoA to succinyl-CoA, thus linking the final catabolic pathways of branched-chain amino acids, odd-chain fatty acids, and cholesterol to the Krebs cycle
how can folate supplementation mask B12 deficiency
blood test for B12 deficiency other than measurin B 12
homocysteinuria
megaloblastic =
large, hypersegmented neutrophils
explain how folatepenia can be masked by B12 supplementation
generally speaking, black urine=
haemolytic anemia