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MINI 4 > B12 and folate deficiency > Flashcards

B12 and folate deficiency Flashcards

1
Q

In what form is Iron toxic ?

A

Free form

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2
Q

Ferric Iron is in what kind of form?

A

Oxidized Fe3+

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3
Q

Ferrous Iron is in what kind of Form?

A

Reduced Fe2+

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4
Q

What is the role of Transferrin?

A

Carry the Ferric form of Iron in the blood

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5
Q

What is the role of Ferritin?

A

Stores the Ferrous form of iron

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6
Q

What is the role of Hemosiderin?

A

storage of iron in a disorganized manner

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7
Q

Looking at lab values the Mean Corpuscular Volume refers to what?

A

The size of the erythrocyte (Microcytic vs Macrocytic)

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8
Q

When looking at lab values the Hemocrit number tells you what?

A

determines the number of RBCs in the body

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9
Q

What does it mean when hemoglobin is low?

A

There will be a decrease in iron carrying capacity

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10
Q

Why is iron binding low with transferrin compared to the others?

A

Because when its bound to transferrin its exposed to oxygen which can cause oxidative damage

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11
Q

What two things faciliate iron uptake?

A

Vitamin C and Ascorbic Acid

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12
Q

What 4 things inhibit iron uptake?

A

1) phytates
2) antacids
3) phosphates
4) tannins

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13
Q

What transports iron from the lumen into the enterocyte?

A

DMT1

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14
Q

What transports iron from the enterocyte into the circulation?

A

Ferriportin

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15
Q

When there is a decrease in transferrin saturation what does that mean?

A

It means there is not enough iron in the blood so transferrin is not taking it up as readily so it just circulates and circulates

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16
Q

If you have an elevated sTFR what does it mean?

A

means there is an increase in receptors to try and bind to iron. So basically not enough iron is present

17
Q

during an infection or cancer pathogens need iron for there growth so what blocks ferriportin from releasing iron into the system?

A

Hepcidin

18
Q

A patient with Inherited hemochromatosis what kind of gene polymorphism does he/she have?

A

HFE polymorphism

19
Q

what does HFE polymorphism do?

A

It upregulates DMT1 during iron transport, so you will have an increase of iron into the cells of the Liver and Cardiac tissue.

20
Q

An accumulation of Hemosiderin due to the HFE polymorphism is bad because of what?

A

Because it will disrupt ferritin storage and destroy its structure.

21
Q

What are 2 examples of acquired Iron Loading anemia?

A

Thalassemia and Sideroblastic anemia

22
Q

During Iron Loading anemia what will you see happen to the RBCS

A

RBCs will breakdown so there is a increase of iron in the circulation

23
Q

In Chronic Liver disease what happens?

A

No longer able to store or regulate iron

24
Q

What is the role of both Folate and B12 metabolism?

A

DNA synthesis

25
Q

Which Deficiency has neurological symptoms like ataxia?

A

B12 deficiency

26
Q

What 2 things are needed to take up B12 ?

A

Intrinsic Factor and colabamine receptor

27
Q

What is pernicious anemia? and why does it occur?

A

B12 Deficiciency because of the loss of Intrinsic factor

28
Q

A patient with a methylmalonyl CoA mutase deficiency will result int he accumulation of what substrate?

A

Methyl malonic acid

29
Q

Methionine synthase needs which Cofactor to function properly?

A

B12

30
Q

In the presence of Methionine synthase what does it convert homocystene to? and What is the role of that pathway?

A

Homocystiene is converted to methionine which is needed for the methylation of DNA/RNA and proteins

31
Q

What is the Ironbound form of protoporphin IX called?

A

Heme

32
Q

What is ferrochelatases job in the bone marrow?

A

It looks for Iron in the bone marrow. Once it finds iron it puts it on protoporphin IX

33
Q

What happens to protoporphin IX after it is formed?

A

Gets put on a globin protein to make hemoglobin

34
Q

Lead Poisoning will inhibit what two things?

A

ALA dehydratase and ferrochalatase

35
Q

Why is iron able to enter the cell when its in the presence of ascorbic acid?

A

Ascorbic acid maintains iron in an available state (reduced state) for transfer by the DMT 1 transport protein

36
Q

What are two Amino acids that can chelate Iron in order to bind to the transferrin ?

A

Glutamate and Aspartate (remember you need acidic amino acids to chelate the iron)

37
Q

Which clinical presentation is expected to result in the greatest loss of bodily iron stores?

A

Menstruation

38
Q

What is the name of a blood test which provides similar information to Transferrin saturation %?

A

Total Iron Binding Capacity (TIBC) (Remember a high saturation % would be a low total iron biding capacity and vice versa)

MINI 4 (23 decks)

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