Iron Deficiency Flashcards
best iron absorption occurs from
- meat in heme
iron uptake influenced by
- iron stores
decreased iron stores will increase
- absorption of iron
nonheme relies on
- stomach acid and other substances
- impede or enhance absorption
purpose of ferric reductase
- reduces dietary iron to ferrous state
purpose of DMT1
- transports ferrous iron into enterocyte
purpose of ferroportin
- helps iron enter circulation
- releases iron from hepatocyte, enterocyte, and macrophages
hepatocytes take up iron from circulation as either
- free iron
- transferrin-bound iron
role of hepcidin
- block action of ferroportin
- blocks release of iron from enterocyte, hepatocyte, and macrophage
- lowers serum iron concentration
when are hepcidin levels increased
- when transferrin bound iron increases
hepcidin responds to what signaling molecule?
- cytokines
role of transferrin
- binds to iron in bloodstream a
- transports it to cells
TIBC
- total iron binding capacity
transferrin saturation
- fraction of available iron binding sites which have iron bound to them
purpose of ferritin
- stores iron in the liver
ferritin in response to iron deficiency
- falls
regulated excretion of iron?
- no regulated excretion of iron!
when does iron leave the body?
- only when cells are lost
ways to lose iron
- menstruation
- pregnancy
- blood donation
- GU blood loss
- GI blood loss
in an adult, iron deficiency is almost always due to
- blood loss
the body in early iron deficiency will use (hemoglobin/stored iron)
- stored iron before dropping hemoglobin
when the body is recovering, which will recover first (stored iron/hemoglobin)
- hemoglobin will recover first
erythrocyte morphology of iron deficiency anemia
- microcytic
- hypochromic
clinical presentation of iron deficiency
- pica
- thrombocytosis
- glossitis
- angular chelitis
- koilonychia
- RLS
- hair loss
- cognitive changes
- cold intolerance
glossitis
- smooth shiny tender tongue
angular chelitis
- sores at corner of mouth
koilonychia
- spooning of the nails
pica
- obsessive consumption of substances with no nutrition value
- generally ice, starch, dirt, or paper
CBC in iron deficiency
- elevation of RDW
- falling of MCV
- hemo/hematocrit fall last
single best test for iron deficiency in a healthy patient
- ferritin test
serum iron levels in iron deficiency
- falls
TIBC in iron deficiency
- increases
transferrin saturation in iron deficiency
- falls
treatment of iron deficiency - treatment of choice
- oral iron
side effects of oral iron
- nausea
- constipation
- black stools
if patients are intolerant of oral iron or have malabsorption
- give IV iron
after birth, what should you do with the baby and placenta
- have all of the placenta blood drained to the baby
half of the blood stores are laid down when in intrauterine development
- last month of intrauterine life
- importance of not being premature
physiologic anemia of infancy
- hemoglobin and reticulocyte values drop after birth
- due to drop in epo production as infants breath oxygen
premature infants versus term infants
- lower nadir
why we don’t give cow’s milk to children under 1 year of age
- protein-induced colitis
- leads to GI bleeding
how to prevent iron deficiency in pregnant and breast-feeding women
- treat iron deficiency
for infants under 12 months who are not breastfed or partially breastfed
- use only iron-fortified supplements
milk consumption values for children ages 1-5 years
- no more than 600 mLs or 20 oz
neuropsychiatric manifestations of iron deficiency in children
- impaired psychomotor function
- pica - for pain chips leading to lead poisoning
what happens if you just give everyone iron in Africa?
- more susceptible to malaria
hepcidin in inflammatory states like ACD
- increases
role of hepcidin on iron absorption from gut
- decrease iron absorption from gut
role of hepcidin in iron export out of hepatocytes
- decrease iron export out of hepatocytes
role of hepcidin in transferrin and TIBC
- decrease transferrin and TIBC
serum iron in Anemia of Chronic Disease
- decreased
TIBC in AOCD
- decreased
- iron low doesn’t feel good at all
ferritin in AOCD
- normal
- elevated
serum iron in iron deficiency
- decreased
TIBC in iron deficiency
- increased
ferritin in iron deficiency
- decreases
