Anemia

Question 1

This measures the amount of transferrin in the blood indirectly so that it indicates the amount of iron transferrin can bind.

Answer 1

Total Iron Binding Capacity (TIBC)

Question 2

What does a high vs low TIBC indicate

Answer 2

High TIBC= (*Hungry”) transferrins are capable of binding A LOT of iron. Indicates iron deficiency.

Low TIBC= (“Full”) transferrins can’t bind much iron. There’s already too much iron in the blood! Iron overload!

Question 3

serum iron

Answer 3

Measures the amount of transferrin-bound iron in the blood.

Question 4

serum ferritin

Answer 4

Measures the amount of ferritin (iron storage protein) in the blood. (Measure of body’s iron stores)

Question 5

% transferrin saturation

Answer 5

How saturated with iron transferrin is.

serum iron/TBIC= % transferrin saturation

Question 6

Serum vs Plasma

Answer 6

Serum- Non-cellular portion of blood WITHOUT clotting factors (ie. fibrinogen)

Plasma- Non-cellular portion of blood WITH clotting factors

Question 7

What is the difference between ferritin and hemosiderin?

Answer 7

Hemosiderin- Minor. A complex of iron with phosphate and hydroxide.

Ferritin- Major. A singular iron storage protein. A major form of storage.

Question 8

Where is hemosiderin vs ferritin stored?

Answer 8

Hemosiderin - Liver and heart (in excess)

Ferritin - Bone marrow, liver, spleen, and skeletal muscle.

Question 9

When is hemosiderin generated?

Answer 9

When the ferritin stores are overburdened the body begins to create hemosiderin.

Question 10

How is hemosiderin generated? (2)

Answer 10

1. RBC breakdown–> Hgb is stored as hemosiderin

2. Abnormal ferritin metabolism

Question 11

What’s the medical term for “spoon-nails” and what does it indicate?

Answer 11

Koilonychia; iron deficiency.

Question 12

What’s the function of Ferroportin?

Answer 12

Transports iron from the inside of the cell (ferrous) to the outside of the cell (ferric).

Question 13

What’s Hepcidin’s function? How does this lead to decreased serum iron in anemia of inflammation?

Answer 13

To suppress ferroportin activity. Macrophages cannot release the iron they ingest from RBC’s. Iron sequestration.

Question 14

What are the common reasons for inadequate levels of Vitamin B12 or Folate? (5)

Answer 14

1. Inadequate Intake (Vegans)
2. Malabsorption (celiac disease)
3. Increased utilization or loss
4. Drug Inhibition
5. Genetics (Vit B12 only)

Question 15

Where is folate absorbed?

Answer 15

Folate is absorbed mostly in the jejunum of the small intestine.

Question 16

Cholecystitis

Answer 16

Inflammation of the gallbladder. Often due to duct being blocked by a gallstone(s).

Question 17

Gallstone

Answer 17

A small, hard mass formed primarily from cholesterol and lipids or primarily from bile salts.

Question 18

What are Howell-Jolly Bodies?

Answer 18

A cluster of nuclear remnants (DNA) in erythrocytes. Seen with basophilic stain.

Question 19

What do Howell-Jolly Bodies indicate about splenic function?

Answer 19

Howell-Jolly bodies indicate poor splenic function. The spleen should be removing these erythrocytes naturally.