iron

Question 1

What are the symptoms of anaemia?

Answer 1

low blood pressure
tiredness, light headiness
heart palpitations (due to change in blood composition)
shortness of breath
cold extremities
amenorrhea ( loss of period)

Question 2

when is someone classed as having iron deficiency anaemia?

Answer 2

ferritin levels of less than 30ng/ml

Question 3

what is Fe2 and Fe3 called?

Answer 3

ferrous and ferric iron

Question 4

what are the cause of iron deficiency anaemia?

Answer 4

hookworm, HIV, Malaria, menstrual blood loss, diet, IBD, bleeding in GI tract e.g. chronic NSAIDs leading to ulcers/ cancer

Question 5

how is IDA treated?

Answer 5

Ferrous sulphate (iron replacement therapy)

Question 6

how is hereditary hemochromatosis treated?

Answer 6

• It is treated by phlebotomy (blood extracted and iron removed before being put back in the body)

Question 7

what are the consequences of hemochromatosis

Answer 7

accumulation of iron in tissues = liver cirrhosis / fibrosis etc
Fenton reactions produce free radicals = increased risk of cancer
oxidative stress then can lead to cell death via apoptic signalling
cardio myopathy, diabetes melitus due to pancreas damage etc

Question 8

How are high hepcidin levels caused in anaemia of chronic disease?

Answer 8

Inflammatory conditions/ cytokines = excess hepcidin release

Question 9

what effect does high levels of hepcidin have in ACD?

Answer 9

iron sequestered in organs such as liver and macrophages in the reticuloendothelial system
inhibits erythropoietin (drives rbc maturation) therefore erythropoiesis is inhibited

Question 10

what type of disorder is coeliac disease?

Answer 10

Autoimmune

Question 11

what triggers coeliac disease?

Answer 11

component of gluten - gliadin

Question 12

what response does the body have in coeliac disease

Answer 12

Gliadin = inflammatory response, antibody is produced against transglutaminase
* This damages the microvilli in the small intestine- the integrity of tight junctions is compromised allowing molecules to diffuse through that shouldn’t including gliadin worsening the inflammatory response and causing more villus atrophy
The villus surface is flattened reducing the large surface area for absorption

Question 13

what are the symptoms of coeliac disease?

Answer 13

osmotic diarrheal (reduced absorption)
pain - villous atrophy
children - failure to thrive
malnutrition = rickets, tooth decay etc
distended stomach / muscle wastage