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Hematology II Winter Snoopy Style > Introduction to Anemia > Flashcards

Introduction to Anemia Flashcards

1
Q

What is anemia?

A

condition in which there is reduced oxygen delivery to tissues, impaired production of RBCs (hypoxia)

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2
Q

Anemias may result from what things?

A

Increased RBC loss
RBC destruction (Hemolysis)
excessive blood loss
Decreased production of rbcs

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3
Q

What two things help you classifiy anemias?

A

Morphology (MCV and MCHC)
Pathophysiology

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4
Q

Describe an anemia with an absolute retic count that is high

A

short RBCs survival
hemolysis and blood loss

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5
Q

Describe an anemia with an absolute retic count that is low, how to you classify them?

A

decreased RBc production
classified via MCV
low (micro) - hgb issues
Norm (norm) - hemolysis/intrinsic
High (macro) - megaloblastic

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6
Q

How much iron is found hgb?
recycling?
diet?

A

2/3rd of total body iron is found in hgb,
it is repeatedly recycled and small amounts are lost but replaced by diet

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7
Q

What are some ways daily iron is effected?

A

menstruation, pregnancy, growth/additional blood loss

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8
Q

Describe Iron metabolism, absorption and the function of DCYTB
how does dietary iron look

A

dietary iron is in the ferric state +3, and is converted to ferrous by reductase enzymes like Duodenal Cytochrome for optimal absorption

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9
Q

T/F optimal pH for absorption is <3.0 (duodenum) and is good for reducing substances like ascorbic acid

A

false. optimal pH is <4.0 and is good for reducing substances like ascorbic acid

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10
Q

What is the function of Divalent metal transport 1? (DMT1)
hint: place…ent

A

Fe+2 carried into enterocyte

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11
Q

What transports iron around the body if it is not stored as ferratin?

A

Ferroportin 1 (FPN1)

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12
Q

What changes iron from the ferrous form back into the ferric form?

A

Hephaestin

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13
Q

What is apoferratin?

A

Intracellular storage form of iron

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14
Q

What is ferroportin 1? (FPN1)

A

protein transports iron across the membrane , carries iron from enterocytes, macrophages and hepatocytes

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15
Q

What is ferroportin regulated by? What does this do?

A

Regulated by Hepcidin
binds to ferroportin and inactivates it
adequate iron - liver creates hepcidin
decreased iron absorption and release

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16
Q

T/F when iron storages drop, hepcidin increases, and iron absorption decreases and release decreases

A

false, when iron storage drops, hepcidin is decreased and iron absorption increases and releases

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17
Q

How is hepcidin regulated? what is the simplified version?

A

regulation is complex/not understood
simplified - involves Hemochromatosis gene (HFE)
Increased iron = HFE allows prod of hepcidin blocking release of iron

18
Q

T/F there is no genetic component to HFE

A

False, mutations in HFE cause hereditary hemochromatosis

19
Q

What does EPO do?

A

stimulates rbc production and enhances hormone production by rubriblasts that suppress hepcidin

20
Q

What hormone is produced by rubriblasts that surpasses hepcidin?

A

Erythroferrone (ERFE)

21
Q

Transport: what picks up Fe+3 in circulation? what happens after it is picked up? Is it soluble?

A

Picked up via transferrin/apotransferrin and is transported to BM for Rbc production and storage
It remains soluble

22
Q

How much iron can a molecule of Transferrin carry?

A

it can carry 2 atoms of Fe+3

23
Q

What allows the transferrin bound iron (Fe+3) to move into nrbcs and retics?
What happens to the complex after this?

A

Transferrin receptor 1
after this, the complex is internalized and acidified/reduced to Fe+2 and carried into the cytoplasm by DMT1

24
Q

What does Ferrocchelatase do?

A

it is the final step in heme synthesis by insertion of Fe+2 into protoprphyin ring

25
Q

T/F TR1 (transferrin receptor 1) decreases when iron is low

A

false, transferrin receptor 1 increases when iron is low

26
Q

Where is iron stored?

A

BM, liver and spleen

27
Q

T/F Senescent rbcs - iron recycled by macrophages

t/f free iron is not toxic and doesn’t need to be sequestered by a protein

A

T

F, free iron is toxic and needs to be sequestered by a protein

28
Q

What does Apoferritin do? Solubility?

A

protein that binds to Fe+3 to form ferritin, storage form of iron in tissues
Water soluble/easily used

29
Q

T/F there is an equilibrium between intracellular stored ferritin and serum ferritin

A

true

30
Q

T/F as cellular iron levels fall, levels of ferritin increase and transferrin receptors on cells decrease

A

false, as cellular iron levels fall, levels of ferritin decrease and transferrin receptors on cells increase

31
Q

T/F when cellular irons increase, ferritin increases and transferrin receptor 1 decreases

A

true

32
Q

Briefly describe Hemosiderin
breakdown product of what?
found in what cells?
solubility?
what kind of aggregates are found/where/stains?
availability?

A

breakdown product of ferritin
found principally in RES cells of liver/spleen/BM
Not water soluble
granules/aggreg of iron can be visualized in tissues (stain w Prussian blue)
less readily available than ferritin

33
Q

What is serum iron? what is special about its testing?

A

measure of transferrin bound iron and it fluncuates so you need to use along w other testing

34
Q

What is TIBC? Total iron binding capacity?
bound to what?
binding capacity?
increased/decreased in?

A

total amount of iron that can be bound to transferrin in serum or plasma
binding capacity is usually 1/3rd saturated
Increased in iron def anemia and dec in iron overload

35
Q

What is transferrin saturation?

A

% saturation of transferrin measured as max amount of iron bound to serum or plasma

36
Q

describe serum ferritin
better measurement than what?
APR?

A

directly proportional to amount of iron stored
better measurement of body storage iron than Serum iron/TIBC
APR

37
Q

Describe soluble transferrin receptors? (STfRs)
inverse..
sloughed from what?
increases?

A

inversely proportional to body iron
sloughed from cells and measured in serum
increases when cellular iron stores are depleted

38
Q

Describe Hepcidin levels
increases with what
decreases when
used in complex with?

A

adequate iron storages, liver increases production of hepcidin (which inactivates ferroportin) decrease iron absorption
Iron storage decreased, hepcidin decrease, more iron absorbed/released
used in complex with IDA AOI

39
Q

Describe Free erythrocyte protoporphyrin (FEP) or Zinc proto..
inverse to ?

A

FEP is heme w/o Iron inserted
ZPP is heme w/ zinc in place of iron
inverse to ferritin level

40
Q

Describe retic count and retic corpuscular hgb (CHr)
indicates?

A

retic # decreased/ineffective EPO
Early indicator of iron deficiency
good indicator of pt response to iron therapy

41
Q

Describe BM Iron

A

Hematology II Winter Snoopy Style (12 decks)

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