Assessment of Nutritional Status - Biochemical (iron deficiency anaemia, calcium status, and vitamin status)

Question 1

What is the most common cause of anaemia?

Answer 1

iron deficiency

Question 2

briefly describe the mechanism behind iron deficiency anaemia

Answer 2

iron is an integral part of healthy red blood cells
lack of iron = lack of oxygen being carried around the body
lack of oxygen to cells causes tiredness and fatigue

Question 3

What are some clinical symptoms of iron deficiency anaemia?

Answer 3

fatigue 
weakness
pale skin 
dizziness
shortness of breath
cold hands/feet

Question 4

what are some pathophysiological consequences of iron deficiency?

Answer 4

low oxygen storage 
low haemoglobin (anaemia) 
mitochondrial dysfunction 
low energy efficiency
low exercise capacity

Question 5

what are the biochemical markers used to diagnose iron deficiency anaemia?

Answer 5

• haemoglobin
• hematocrit
• transferrin
• serum iron
• serum ferritin
• mean corpuscular value (MCV)
• total iron binding capacity (TIBC)

Question 6

what is haemoglobin?

Answer 6

iron containing molecule that carries oxygen in red blood cells

Question 7

What is haemodilution

Answer 7

Increase in plasma volume (usually seen in pregnancy) that causes haemoglobin level to decrease

Question 8

What does a hematocrit test measure?

Answer 8

the percentage of red blood cells making up the volume of the blood

depends on:
number and size of RBC’s

Question 9

Describe transferrin and it’s role in the body

Answer 9

transferrin is a glycoprotein that binds to iron for transportation around the body

Question 10

How does transferrin level diagnose iron deficiency anaemia?

Answer 10

Levels of transferrin increase in ppt with iron deficiency anaemia

Question 11

what is serum iron a measure of?

Answer 11

the measure of the amount of iron bound to transferrin

Question 12

what is serum ferritin?

Answer 12

the primary storage form of iron in the body

Question 13

which is the most effective biochemical test for iron deficiency anaemia?

Answer 13

Serum ferritin test

Question 14

describe the term ‘anaemia’.

Answer 14

anaemia is below normal levels of haemoglobin

Question 15

describe microcytic anaemia

Answer 15

Below average sized red blood cells

Question 16

describe macrocytic anaemia

Answer 16

abnormally large red blood cells

most common form of macrocytic anaemia is megaloblastic anaemia.

Question 17

describe hypochromic anaemia

Answer 17

abnormal level of haemoglobin
red blood cells are paler than usual

often overlaps with microcytic anaemia as RBC are usually small too

Question 18

which biochemical test would you do in the 1st stage of iron deficiency?
what would it show?

Answer 18

serum ferritin test

would show a decreased level of serum ferritin as iron store depletes

Question 19

which biochemical test would you do in the 2nd stage of iron deficiency?
what would it show?

Answer 19

transferrin test

transferrin level will increase

Question 20

which biochemical tests would you do in the 3rd stage of iron deficiency?

Answer 20

haemoglobin test - Hb levels decreased
MCV test - levels decreased
serum ferritin test - level decreased

Question 21

how is calcium status measured?

Answer 21

there is no biochemical test to measure calcium status
this is because 99% calcium in the body is in the bones

DEXA scan to assess bone health with give indication of Ca store

Question 22

Describe a static and functional test used to assess vitamin A status

Answer 22

Static - serum or breast milk Vit A concentration

Functional - dark adaptation test

Question 23

why is serum vitamin C not an accurate measure of total body Vit C status?

what is measured as an alternative?

Answer 23

serum Vit C level reflects dietary intake of vitamin C

leukocyte level of Vit C is measured to more accurately reflect the pool of Vit C in the body

Question 24

How is vitamin B12 deficiency measured?

Answer 24

MCV test

Hb test

Question 25

once a vitamin B12 deficiency is recognised, what test is used to determine the cause?

Answer 25

Schilling test

Question 26

What are some important roles of calcium in the body?

Answer 26

blood clotting
tooth and bone formation
muscle contraction
cell membrane structure

Question 27

What are some important roles of Vitamin C in the body?

Answer 27

promotes iron absorption 
antioxidant 
protects against cancer
protects against scurvy 
formation of collagen