Iron Deficiency

Question 1

best iron absorption occurs from

Answer 1

• meat in heme

Question 2

iron uptake influenced by

Answer 2

• iron stores

Question 3

decreased iron stores will increase

Answer 3

• absorption of iron

Question 4

nonheme relies on

Answer 4

• stomach acid and other substances

- impede or enhance absorption

Question 5

purpose of ferric reductase

Answer 5

• reduces dietary iron to ferrous state

Question 6

purpose of DMT1

Answer 6

• transports ferrous iron into enterocyte

Question 7

purpose of ferroportin

Answer 7

• helps iron enter circulation

- releases iron from hepatocyte, enterocyte, and macrophages

Question 8

hepatocytes take up iron from circulation as either

Answer 8

• free iron

- transferrin-bound iron

Question 9

role of hepcidin

Answer 9

• block action of ferroportin
• blocks release of iron from enterocyte, hepatocyte, and macrophage
• lowers serum iron concentration

Question 10

when are hepcidin levels increased

Answer 10

• when transferrin bound iron increases

Question 11

hepcidin responds to what signaling molecule?

Answer 11

• cytokines

Question 12

role of transferrin

Answer 12

• binds to iron in bloodstream a

- transports it to cells

Question 13

TIBC

Answer 13

• total iron binding capacity

Question 14

transferrin saturation

Answer 14

• fraction of available iron binding sites which have iron bound to them

Question 15

purpose of ferritin

Answer 15

• stores iron in the liver

Question 16

ferritin in response to iron deficiency

Answer 16

• falls

Question 17

regulated excretion of iron?

Answer 17

• no regulated excretion of iron!

Question 18

when does iron leave the body?

Answer 18

• only when cells are lost

Question 19

ways to lose iron

Answer 19

• menstruation
• pregnancy
• blood donation
• GU blood loss
• GI blood loss

Question 20

in an adult, iron deficiency is almost always due to

Answer 20

• blood loss

Question 21

the body in early iron deficiency will use (hemoglobin/stored iron)

Answer 21

• stored iron before dropping hemoglobin

Question 22

when the body is recovering, which will recover first (stored iron/hemoglobin)

Answer 22

• hemoglobin will recover first

Question 23

erythrocyte morphology of iron deficiency anemia

Answer 23

• microcytic

- hypochromic

Question 24

clinical presentation of iron deficiency

Answer 24

• pica
• thrombocytosis
• glossitis
• angular chelitis
• koilonychia
• RLS
• hair loss
• cognitive changes
• cold intolerance

Question 25

glossitis

Answer 25

- smooth shiny tender tongue

Question 26

angular chelitis

Answer 26

- sores at corner of mouth

Question 27

koilonychia

Answer 27

- spooning of the nails

Question 28

pica

Answer 28

- obsessive consumption of substances with no nutrition value - generally ice, starch, dirt, or paper

Question 29

CBC in iron deficiency

Answer 29

- elevation of RDW - falling of MCV - hemo/hematocrit fall last

Question 30

single best test for iron deficiency in a healthy patient

Answer 30

- ferritin test

Question 31

serum iron levels in iron deficiency

Answer 31

- falls

Question 32

TIBC in iron deficiency

Answer 32

- increases

Question 33

transferrin saturation in iron deficiency

Answer 33

- falls

Question 34

treatment of iron deficiency - treatment of choice

Answer 34

- oral iron

Question 35

side effects of oral iron

Answer 35

- nausea - constipation - black stools

Question 36

if patients are intolerant of oral iron or have malabsorption

Answer 36

- give IV iron

Question 37

after birth, what should you do with the baby and placenta

Answer 37

- have all of the placenta blood drained to the baby

Question 38

half of the blood stores are laid down when in intrauterine development

Answer 38

- last month of intrauterine life | - importance of not being premature

Question 39

physiologic anemia of infancy

Answer 39

- hemoglobin and reticulocyte values drop after birth | - due to drop in epo production as infants breath oxygen

Question 40

premature infants versus term infants

Answer 40

- lower nadir

Question 41

why we don't give cow's milk to children under 1 year of age

Answer 41

- protein-induced colitis | - leads to GI bleeding

Question 42

how to prevent iron deficiency in pregnant and breast-feeding women

Answer 42

- treat iron deficiency

Question 43

for infants under 12 months who are not breastfed or partially breastfed

Answer 43

- use only iron-fortified supplements

Question 44

milk consumption values for children ages 1-5 years

Answer 44

- no more than 600 mLs or 20 oz

Question 45

neuropsychiatric manifestations of iron deficiency in children

Answer 45

- impaired psychomotor function | - pica - for pain chips leading to lead poisoning

Question 46

what happens if you just give everyone iron in Africa?

Answer 46

- more susceptible to malaria

Question 47

hepcidin in inflammatory states like ACD

Answer 47

- increases

Question 48

role of hepcidin on iron absorption from gut

Answer 48

- decrease iron absorption from gut

Question 49

role of hepcidin in iron export out of hepatocytes

Answer 49

- decrease iron export out of hepatocytes

Question 50

role of hepcidin in transferrin and TIBC

Answer 50

- decrease transferrin and TIBC

Question 51

serum iron in Anemia of Chronic Disease

Answer 51

- decreased

Question 52

TIBC in AOCD

Answer 52

- decreased | - iron low doesn't feel good at all

Question 53

ferritin in AOCD

Answer 53

- normal | - elevated

Question 54

serum iron in iron deficiency

Answer 54

- decreased

Question 55

TIBC in iron deficiency

Answer 55

- increased

Question 56

ferritin in iron deficiency

Answer 56

- decreases