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Hematology week 1 > Iron deficiency > Flashcards

Iron deficiency Flashcards

1
Q

Inorganic iron salts exists in 2 forms

A

– Ferrous (2+) “reduced” : gained an electron
– Ferric (3+) “oxidized” : lost an electron

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2
Q

is an essential element in humans, being the central ion in heme (the non-protein component of hemoglobin, myoglobin, and cytochromes)

A

iron

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3
Q

Iron deficiency causes a failure

A

in heme synthesis

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4
Q

Iron deficiency results in the production of red cells that are

A

smaller than normal (microcytic) and paler than normal (hypochromic)

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5
Q

an essential component of hemoglobin, and is responsible for binding oxygen in a pocket between the globin chain and the porphyrin plate.

A

Iron in the ferrous form

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6
Q

iron deficiency leads to

A

anemia and tissue hypoxia

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7
Q

what is highly toxic to the cells and must be bound to protein at all time

A

Free iron

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8
Q

what is Haber-Weiss reaction

A

Fe+2 + H2O2 Fe+3 + OH- + OH

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9
Q

Free-radicals can attack:

A

– Cellular membranes - DNA – Proteins

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10
Q

Iron excess possibly related to

A

cancers and cardiac toxicity

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11
Q

about (_) of iron is lost from the body per day

A

1 mg

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12
Q

how is iron usually lost

A

through sloughed mucosal epithelial cells or blood loss

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13
Q

The majority of iron required by the body is acquired by

A

recycling iron from senescent red cells.

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14
Q

2 ml of blood contains approximately (_) of iron.

A

1 mg

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15
Q

Daily red cell production requires

A

20 - 25 mg Fe2+

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16
Q

only (_) of iron is absorbed each day from the diet

A

1 - 1.5 mg

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17
Q

Adult human body contains about

A

3000-4000 mg of iron

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18
Q

Most of the iron within the body is found in

A

hemoglobin within erythrocytes (about 1800 mg of iron)

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19
Q

Iron is also stored in macrophages and in hepatocytes, which represents the storage pool of iron

A

about 1600 mg of iron

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20
Q

Storage iron occurs in two forms

A

– Ferritin (soluble)
– Hemosiderin (insoluble)

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21
Q

Excess iron can be complexed to phosphate and
hydroxide to form

A

hemosiderin

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22
Q

Abnormal quantities of hemosiderin can occur

A

after internal hemorrhage (bruising)

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23
Q

Hemosiderin can also accumulate inside cells that normally

A

metabolize red blood cells, if there is increased red blood cell breakdown

24
Q

accumulations of hemosiderin occur in the liver

A

in some kinds of anemia or after large numbers of blood transfusions

25
Q

a glycoprotein synthesized in the liver having a central role in the body’s metabolism of iron

A

Transferrin

26
Q

Each mole of transferrin can transport

A

2 moles of Fe3+

27
Q

how does the iron dissociate from transferrin

A

The acidic pH of the lysosome

28
Q

Dietary iron is obtained from

A

from inorganic (non- heme Fe 3+) or animal sources via (heme Fe 2+)

29
Q

Plasma transfer of iron from enterocytes to the transport protein, () , occurs through specific iron channels, called () and is facilitated by a protein called (_)

A

apotransferrin
ferroportins
hephaestin

30
Q

When apotransferrin binds iron, it is called

A

transferrin

31
Q

a main iron regulating protein decreases ferroportin and thus decreases iron absorption

A

Hepcidin

32
Q

Iron absorption mainly takes place in

A

proximal small intestine

33
Q

half clearance time of transferring bound iron is

A

60-90 minutes

34
Q

Iron absorbed from the intestine is stored as () in () epithelium or transported in plasma as (_)

A

ferritin
intestinal
transferrin

35
Q

Erythroid progenitors obtain iron for hemoglobin synthesis from

A

1-plasma transferrin
2- from recycling of senescent erythrocytes by macrophages in bone marrow, spleen and liver.

36
Q

Excess Iron also stored in macrophages as

A

ferritin

37
Q

Globins are broken down to

A

amino acids

38
Q

porphyrin ring which is converted

A

to bilirubin

39
Q

In macrophages, (_) is a ferroxidase and facilitates the transfer of macrophage iron to transferrin

A

ceruloplasmin

40
Q

(_) downregulates ferroportin causing iron sequestration in macrophages.

A

hepcidin

41
Q

Whole body iron levels are regulated primarily at the level of absorption

A

by enterocytes

42
Q

active excretion of iron occurs by

A

bleeding or sloughing of iron- laden enterocytes

43
Q

Regulation of iron uptake by enterocytes and release of iron stores from macrophages and hepatocytes is mediated by the hormone

A

hepcidin

44
Q

where is hepcidin produced

A

liver

45
Q

decreases serum iron by decreasing iron absorption and preventing macrophages from releasing iron

A

hepcidin

46
Q

Hepcidin is regulated by

A

iron levels and erythropoiesis

47
Q

Hepcidin is also increased by inflammatory cytokines particularly

A

IL-6, and reduces available iron during inflammatory processes

48
Q

what increases iron absorption

A

Citrate and ascorbate

49
Q

what decreases iron absorption

A

Tannates

50
Q

Duodenal microvilli contain (_) to promote absorption of ferrous iron

A

ferric reductase

51
Q

what is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood, or a lowered ability of the blood to carry oxygen

A

Anemia

52
Q

Types of Anemia based on Clinical Picture

A

*Iron deficiency Anemia
*Megaloblastic Anemia
*Pernicious anemia
*Aplastic Anemia
*Hemolytic Anemia
-Thalassemia anemia
-Sickle cell Anemia

53
Q

Laboratory testing for For Iron Defeciency Anemia

A
  • Serumiron
  • Totalironbindingcapacity(TIBC)
  • Serumferritin
  • Completebloodcount(CBC)
  • Bonemarrowbiopsy
  • Liverbiopsy
54
Q

Ferritin may be increased in serum by:

A

– Tissue release (hepatitis, leukaemia, lymphoma)
– Acute phase response (tissue damage, infection, cancer)

55
Q

Causes of Iron Deficiency Anemia

A

*Increased iron utilization
– Postnatal growth spurt
– Adolescent growth spurt
* Physiologic iron loss
– Menstruation
– Pregnancy
* Pathologic iron loss
– GI bleeding
– Genitourinary (GU) bleeding
* Decreased iron intake
– Meat poor diet
– Malabsorption

56
Q

General anemia’s symptoms

A

– Fatigue
– Dizziness
– Headache
– Irritability
– Palpitation
– Dry, pale skin
– Hair loss
– Brittle nails

Hematology week 1 (5 decks)

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