Fatigue (I Feel Tired) Flashcards
What is the role of the hormone erythropoietin?
It stimulates red blood cell production in the red bone marrow.
Where and when is erythropoietin produced?
In the kidneys, in response to hypoxaemia.
Where does haematopoiesis take place in an adult?
The bone marrow and thymus.
Where in the body is iron primarily absorbed?
Duodenum
Where in the body is B12 primarily absorbed?
Terminal ileum
Where in the body is folate primarily absorbed?
Jejunum
Where is iron stored?
In the liver or bone marrow macrophages.
What molecule is iron bound to whilst in storage?
Ferritin
What does ‘total iron binding capacity (TIBC)’ tell us about a patient?
How many transferrin molecules are in the blood.
What does ‘transferrin saturation (%)’ tell us about a patient?
How many transferrin molecules are bound to iron.
What do ferritin levels tell us about a patient?
How much iron is in storage.
What is a loss of corticomedullary differentiation on kidney ultrasound a sign of?
Chronic fibrous scarring
What is the normal length of the kidneys?
Around 11-14cm
How should the cortex of a healthy kidney look on ultrasound compared to the liver?
The cortex of a healthy kidney on ultrasound should look less echo dense (blacker) than the liver.
What are the target transferrin saturation and serum ferritin in a patient with Chronic Kidney Disease (CKD)?
Transferrin saturation > 20%
Serum ferritin > 100ug/L
What is the major cause of anaemia in Chronic Kidney Disease (CKD) patients?
Erythropoietin deficiency
What are the two primary factors that cause renal bone disease?
High phosphate levels (due to impaired excretion) and failure of renal tubular cells to activate vitamin D
How can vitamin D deficiency present? (4)
Fatigue, bone pain, muscle aches and low mood.