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PMCOL 344 > Hematopoietic System-Iron > Flashcards

Hematopoietic System-Iron Flashcards

1
Q

what is Hematopoiesis

A

formation of blood cells from stem cell precursors

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2
Q

what composes the hematopoietic system

A

bone marrow, blood, thymus, lymph nodes, kidney spleen liver

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3
Q

what is the role of the kidney in the hematopoietic system

A

produces erythyopoietin

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4
Q

what is the role of the spleen in the hematopoietic system

A

breakdown of RBC, recycle hemoglobin, iron

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5
Q

what is the role of the liver in the hematopoietic system

A

stores iron

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6
Q

what are the 2 main pathways that stem cells can form (like blood cells)

A

myeloid and lymphoid

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7
Q

what is anemia

A

insufficient RBC mass to adequately deliver oxygen to peripheral tissues due to decrease in RBC number or concentration of hemoglobin

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8
Q

what are anemia symptoms

A

fatigue, weakness, lightheadedness, dyspnea, decreased exercise tolerance

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9
Q

what are 2 main types of anemia

A

chronic and acute

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10
Q

what is acute anemia

A

severe blood loss

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11
Q

what kind of anemia is acute anemia and why

A

normocytic because there is normal volume of the RBC

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12
Q

what are 3 main types of chronic anemia

A

microcytic and macrocytic and renal failure anemia

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13
Q

what is anemia of chronic renal failure

A

problem with kidneys, kidneys cant make EPO

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14
Q

what are 5 causes of chronic anemia

A
  • dietary deficiency
  • chronic minor blood loss
  • disorder of organ responsible for manufacture/uptake of factors essential for RBC production
  • depression of bone marrow
  • haemolytic anemias
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15
Q

what causes microcytic anemias

A

not enough iron

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16
Q

what causes macrocytic anemias

A

not enough folate or B12

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17
Q

what are 3 things that cause depression of bone marrow

A

drug toxicity, radiation/radiotherapy, diseases of bone marrow

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18
Q

what are 2 haemolytic anemias

A

sickle cell, thalassemia

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19
Q

what are 4 examples of hematinic agents

A

iron compounds
vit B12 compounds
folates
haematopoietic growth factors - EPO

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20
Q

when do you use iron compounds

A

for iron deficiency anemia

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21
Q

what are the RBC like structually in iron deficiency anemia and why

A

they are smaller due to lower Hb content-microcytic

also hypochromatic

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22
Q

what % of body iron circulates as Hb in RBCs

A

65%

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23
Q

what % of body iron is stored as ferritin in tissues

A

25%

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24
Q

what % of body iron is myoglobin as transferrin

A

10%

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25
what is ferritin
protein that binds to iron in tissue
26
what is transferrin
peptide that binds to iron
27
where is myoglobin
in skeletal muscle
28
where does iron absorption occur
in duodenum
29
how much iron gets absorbed daily
1mg
30
what is the storage form of iron
ferritin
31
how can iron enter the duodenum
either absorbed as heme-iron (HCP1) or taken up via DMT1 with H+
32
how does heme iron enter duodenal cell
HCP1
33
how does non heme iron enter duodenal cell
DMT1 with H+ co transport
34
how does Fe3+ become Fe2+
via DCYTB
35
which form of iron is better absorbed (charge)
Fe2+
36
what happens to heme iron once its inside the cell
heme oxidase releases Fe++ from it
37
what are 2 main things that can happen with free iron in the cell
ferroportin gets it out of the cell into blood or it makes ferritin inside the cell
38
what happens once Fe++ leaves the duodenal cell
hephaestin turns it into Fe+++
39
what does Fe+++ do (after it left the cell)
joins plasma apotransferrin to become transferrin
40
what does heme oxidase do
releases Fe2+ from heme iron
41
what happens when transferrin enters a new cell (4)
- joins a lysosome - breaks into apotransferrin (which leaves the cell) and Fe+++ - reductase turns Fe+++ to Fe++ - Fe++ leaves lysosome and is used to make Hb
42
what is it called when transferrin fuses with lysosome
endosome
43
what are 3 main causes of iron deficiency anemia
inadequate dietary intake, inadequate absorption, chronic blood loss
44
what 2 things can cause inadequate absorption
gastrectomy, diseases of GI tract
45
what are some things that cause chronic blood loss
GI bleeding things (ulcers, cancer), menorrhagia, hookworm
46
what are 3 types of oral iron therapy
ferrous sulphate, ferrous fumarate, ferrous gluconate
47
what is the most common iron supplement
ferrous sulphate
48
what are some things that decrease iron absorption and why
things that chelate iron, antacids and PPIs
49
what is a thing that increase iron absorption
vitamin C
50
what are 3 types of natural things that affect iron absorption + how
phytates (nuts, seeds, grains - inhibit iron) polyphenols (beans, tea, coffee - interfere) Ca++ Zn++ Mg++ compete for upate
51
what are some adverse effects of iron oral therapy
cramps, nausea, heartburn, constipation, diarrhea, black stools, metal taste
52
what can iron overload do generally, and which organ is most effected
damage several organs, especially liver
53
how can you treat Fe toxicity
Fe chelation
54
when do you use parenteral iron therapy (3)
when patient cant absorb oral iron, GI surgery, GI inflammation
55
what are 2 types of parenteral iron therapy
iron dextran IV and iron sucrose IV
56
what is the structure of parenteral iron
central core of ferric hydroxide surrounded by carbohydrate shell
57
what is the size of iron dextran or sucrose
varied
58
what 3 things do parenteral iron therapies vary in
molecular size, redistribution to tissues, adverse effects
59
what is the mechanism of parenteral iron therapy
ingested by macrophage cells which convert Fe3+ to Fe2+ferrireductases
60
what is the dose of parenteral iron therapy like and why
slow release/ test dose for acute hypersensitivity because risk of anaphylaxis (esp. iron dextran)
61
what is iron dextran vs sucrose
dextran is bigger
62
what are some unwanted effects of parenteral iron therapy
pain in injected vein, flushing, nausea, hypotension, headache, myalgia, fever, anaphylaxis
63
what kind of anemia would you get with NSAID induced gastritis
iron deficiency

PMCOL 344 (27 decks)

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