Hematopoietic Growth Factors Flashcards

1
Q

Nutritional growth factors

A
  • Ferrous Iron
  • Folic Acid
  • Hydroxocobalamin (b12)
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2
Q

Hormonal Growth factors

A
  • Epoeitin alpha, Darbopoetin
  • G-CSF
  • GM-CSF
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3
Q

Who is must susceptible to anemia?

A

*women-childbearing age

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4
Q

What type of anemia does B12 cause?

A

Megaloblastic

Not macrocytic?

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5
Q

Erythropoiesis

required nutrients

A
  • iron
  • folic acid
  • Hydroxycobalamine
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6
Q

Erythropoiesis

Required growth factors

A

G-CSF
GM-CSF
Epoetin

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7
Q

Most common anemia?

A

Iron deficiency

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8
Q

Non-heme iron in non-meat foods must be

A

Reduced to ferrous iron (ascorbate/Vit C + HCl helps)

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9
Q

Iron

Absorption

A
  • duodeunum + proximal jejunum

* increases w/ low stores

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10
Q

Iron

Elimination

A
  • no excretion MOA
  • regulate - change absorption/storage
  • body iron stores high = stored
  • body iron stores low = transported ot bone marrow for Hb production
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11
Q

Apoferritin

A
  • Free iron low = synthesis inhibited, iron to transferrin

* Free iron high = synthesis stimulated, iron to ferritin (no toxicity)

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12
Q

Iron toxicity
(Kills gut lining)

Acute Tx

A

Deferoxamine

Bowel irrigation

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13
Q

Iron toxicity
(Heart, liver, pancreas, other)

Chronic

A

Deferoxamine
Deferasirox - oral

Phlebotamy

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14
Q

Iron salts

A
  • 1/4 absorbed

* cheap

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15
Q

Iron salts

S.E.

A
  • Epigastric distress

* Abdominal cramps

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16
Q

Iron Dextran

A
  • can’t tolerate oral iron
  • IV - ferric hydroxide (IV can metab)
  • other preps (less anaphylaxis) - Na Ferric gluconate, iron sucrose
17
Q

B12 deficiency

S.E.

A

Neuro

18
Q

Folate pathway

A

Dietary folate –> 5me-THF to Tetrahydrofolic acid BY B12 COFACTOR w/ enzyme
Methianine created in process
5,10 MeTHF to purines to DNA OR Dihydrofolate (to make DNA)
**
B12 Deficient = Folate Deficient

19
Q

Folate deficiency

Tx

A

Folic acid supplements

  • enters to Dihydrofolate reductase
  • prevent anemia of Vitamin B12 (sidestepping cofactor step)
20
Q

Vitamin B12

Storage

A

*5 yrs worth stored in Liver

*

21
Q

B12 in what?

A

Meat, eggs, dairy

22
Q

Vitamin B12

Absorption

A

Intrinsic factor (parietal cells in stomach)

  • distal ileum
  • watch GI disorders! Stomach removal!
23
Q

Vitamin B12

Tx

A
  • IV - hydroxycobalamin

* folic acid - correct anemia ONLY (no neuro)

24
Q

Folate stores

A

1-6 months

Liver

25
Q

Folate prevents

A

Neural tube defects

26
Q

Folate sources

A

Green veges, liver, fruits

27
Q

Folic Def

Tx

A

Folic acid

28
Q

EPO responsive cells

A
  • Committed progenitors - Blast cell –> colony forming unit –>pro/erythroblast
  • causes dividing + differentiation
29
Q

Epoetin alpha

Use

A
  • Anemia - chronic renal failure

* Anemia - due to AZT in HIV patients

30
Q

Epoetin alpha

S.E.

A
  • iron deficiency - give supplement
  • retics up from marrow
  • HTN/clotting
31
Q

Darbepoetin alpha

A
  • clearance slowed from Epoetin (chronic renal patients)

* SE more severe (longer t1/2)

32
Q

G-CSF

A
  • stimulates neutrophil (granulocyte) lineage

* Chemokyne = attracts stem cells for autologous stem cell transplant

33
Q

GM-CSF

A

*stimulates Neutrophils + erythroid + megakaryocyte

34
Q

Thrombopoietin

A
  • up megakaryocytes
35
Q

Interleukin II

A

*up megakarycytes + thormbocytes