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Haematology > Iron > Flashcards

Iron Flashcards

1
Q

Where does iron absorption mainly occur?

A

Duodenum

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2
Q

What enhances iron absorption?

A

Haem iron
Ascorbic acid reduces iron to Fe2+
Alcohol

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3
Q

What inhibits iron absorption?

A

Tannins - tea
Phytates - cereal, nuts, seeds
Calcium - dairy

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4
Q

Describe the absorption of Iron into the enterocyte

A

Haem iron is absorbed by its dedicated transporter

Non-haem iron is absorbed by DMT1

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5
Q

What enzyme converts Fe3+ to Fe2+?

A

Duodenal cytochrome B

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6
Q

What protein facilitates iron export?

A

Ferroportin

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7
Q

What protein controls iron absorption?

A

Hepcidin

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8
Q

Describe hepcidin

A

Produced in the liver in response to increased iron and inflammation - binds to ferroportin and causes it to degrade. Iron is trapped in duodenal cells and macrophages

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9
Q

State three ways to assess iron status

A

Functional iron - Hb concentration
Transport - % saturation of transferrin
Storage iron - serum ferritin

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10
Q

How many binding sites does transferrin have?

A

Two

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11
Q

Name the two variations of transferrin

A

Holtransferrin

Apotransferrin

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12
Q

When does ferritin rise?

A

Increased iron

Inflammation - acute phase protein

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13
Q

What can cause iron deficiency?

A

Insufficient intake
Bleeding
Malabsorption

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14
Q

Name the two types of iron overload

A

Primary - haemochromatosis

Secondary - transfusions

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15
Q

Which gene is mutated in haemochromatosis?

A

HFE leading to decreased hepcidin synthesis

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16
Q

State the clinical features of haemochromatosis

A

Weakness, fatigue, joint pain, arthritis, impotence, cirrhosis, diabetes, cardiomyopathy

17
Q

When does haemochromotosis usually present?

A

Middle age - 30s/40s/50s

18
Q

How is haemochromatosis diagnosed?

A

Genetic test

Phenotype - transferrin saturation, ferritin, liver studies

19
Q

What is in place to ensure early diagnosis?

A

Family screening

20
Q

How is haemochromatosis treated?

A

Weekly venesection - <20ug/l initially and <50 thereafter

21
Q

How much iron is in one unit of red cell transfusion?

22
Q

What causes secondary iron overload?

A

Transfusion

Excess absorption and overactive erythropoiesis

23
Q

What disorders can lead to iron overload due to treatment?

A

Thalassaemia, sideroblastic anaemia, red cell aplasia, myelodysplasia

24
Q

How is secondary iron overload treated?

A

Iron chelating drugs

  • desferrioxamine
  • deferiprone
  • deferasirox

Haematology (18 decks)

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