Iron Deficiency Flashcards
Where in the body is iron stored and bound to ferritin?
In macrophages and hepatocytes
Decreased iron stores will increase/decrease absorption
Increase
Iron in veggies is absorbed ___ as effectively as the iron in meat
1/10
Where in the body is iron absorbed?
Duodenum (i.e. duodenal enterocyte)
Dietary ferric iron must be ____ and turned into ferrous iron
reduced
Enzyme that reduces ferric iron to ferrous iron
Ferric reductase
Ferrous iron is transported into the circulation from the duodenal enterocyte, hepatocyte, and macrophages via _______
ferroportin
Iron may exist in circulation as free iron or bound to _______
transferrin
Hepcidin blocks the action of _____
Ferroportin
What is the consequence of hepcidin on serum iron levels?
Decreases them because it blocks ferroportin which shuttles iron into the circulation from storage sites
Certain microorganisms use iron as a growth factor, so the body’s response to invasion is to produce cytokines that signal hepcidin to block ______ to decrease iron levels in the blood
ferroportin
In iron deficiency, there is increased/decreased transferrin
Increased
In iron deficiency, the ferritin levels increase/ decrease
Decrease
Will a patient lose iron from the liver or the RBCs first?
Liver because that is where the iron is stored
TIBC will increase/decrease in iron deficiency
Increase
% transferrin saturation will increase/decrease in iron deficiency
Decrease; there is more transferrin, but there is not more iron to bind to the transferrin
What are the most iron rich foods?
Liver, oysters, clams, mussels
People lose a little bit of iron by shedding gut and ____ cells
skin
What are some ways to lose iron?
- Menstruation (8-72 mg/month)
- Pregnancy (1000 mg in pregnancy and lactation)
- Blood donation
- GI blood loss
- GU loss
I unit of packed RBCs contains about how much iron?
200-223 mg
Iron deficiency in adults is almost always due to ____ loss
blood
Koilonychia is seen in patients with ___ ____
Iron deficiency
Spooning of the nails is referred to as
Koilonychia
Glossitis is seen in patients with
Iron deficiency
Pica is the craving for non-food items seen in ____ _____
Iron deficiency
50% of patients present with this symptom of iron deficiency and want to only eat ice
Pica
Thrombocytosis is key to this deficiency
Iron deficiency
What is the most common cause of non-male patterned baldness?
Iron deficiency
In a healthy patient, what tests should you perform first?
CBC and ferritin test
What is the single best test for iron deficiency?
Ferritin levels test; if less than 15 then are iron deficient
In iron deficiency, serum iron increases/decreases
decreases
In iron deficiency, transferrin (TIBC) levels increase/decrease
increases
What is the treatment of choice to treat iron deficiency?
Oral iron replacement
What are the side effects of oral iron supplement?
- Nausea
- Constipation
- Black stools
If patients cannot take oral iron, what can they take?
IV iron
IV iron should be given to patients with inflammatory bowel disease and patients who underwent _____ bypass
gastric
What is the risk of taking IV iron?
Anaphylaxis
In newborns, cutting the cord should be delayed for at least a ___ to allow for the blood in the placenta to travel to the baby
minute
After a baby is born, you want to keep it above/below the placenta
below
Being pre-mature puts the child at risk for being ___ deficient
iron
As soon as an infant begins to breath air, it stops production of ___
EPO
All babies are a little ____ due to them not making as much EPO when they take their first breaths
anemic
In puberty, guys can get iron deficient due to stripping iron from packing on muscle and bone and girls begin to _______
Menstruate
In puberty, need to keep an eye out for _____disorders
Eating
Highest prevalence of iron deficiency in children occurs in children living at or below the _____ line
Poverty
About __ of the term newborn’s iron stores are laid down in the last month in utero and this means that premies will be more/less prone to iron deficiency
1/2; more
NEVER give a child what animal product before 12 months and why
Cow’s milk; they will be allergic and can develop colitis and have GI bleed
If a child is obese and has a very low Hb, then what animal product could they be ingesting in large amounts?
Cow’s milk
You should treat iron-deficiency in ____ and breast-feeding women
Pregnant
Iron deficiency in children may cause impaired ______ development and ____ for paint chips that increases risk for ____ toxicity
psychomotor; pica; lead
Iron supplementation in pregnant women causes reduction in what?
Childhood mortality
800 million people have ___
Iron deficiency anemia
Being iron deficient means that a person can/ cannot get infected with malaria
Cannot
In Tanzania, there was a study done where people who were supplemented with iron were infected with ___ more than those who were not
malaria
In anemia of chronic disease, inflammatory states lead to cytokines sequestering iron from bloodstream by increasing the levels of ______
Hepcidin
Hepcidin works by:
- Decreasing iron absorption from gut
- Decreasing iron export out of liver cells
- Decreasing transferrin and TIBC
Result of anemia of chronic diseas
Low transferrin, low serum iron, low TIBC, normal or elevated ferritin
Ferritin is considered an acute ____ reactant and is elevated in disease and inflammation
phase
