Iron Deficiency Flashcards
What yields a higher percentage of iron absorption…meat heme or nonheme?
meat heme…accounts for 2/3 of iron store and only 1/3 of iron intake
transferrin role
binds iron in the bloodstream and transports it to cells
TIBC and how it changes when iron deficient?
total iron binding capacity
it goes up when iron deficient
Transferring saturation
fraction of available Fe binding sites which have iron bound…goes down when iron deficient
what is the protein that stores iron within cells?
ferritin
What happens to ferritin levels as become iron deficient?
they fall because all the iron is getting released
is there regulated excretion of iron?
no iron only lost when cells are lost directly
common modes of iron loss (6)
shedding gut and skin epithelial cells menstruation pregnancy blood donation GI blood loss GU loss after intravascular hemolysis
what is the most common cause of iron deficiency in adults?
blood loss…but sometimes can have malabsorption or dietary insufficiency
clinical presentation of iron deficiency
some can be asymptomatic…some anemic
sign of source of blood loss,
other effects of iron deficiency that show up
glossilitis angular chelitis koilonychia Pica Thrombocytosis restless leg syndrome hair loss cognitive changes cold intolerance
glossilitis
smooth shiny tongue
angular chelitis
sores at corners of mouth
koilonychia
spooning of finger nails
Pica (pagophagia)
obsessive compulsion of substances with no nutritional value
examples are ice, starch, dirt, paper
First sign of iron deficiency on CBC
rising RDW and falling MCV
hemoglobin and hematocrit fall last
ferritin levels in healthy patient with iron deficiency
ferritin levels will be decreasing
this is best sign of iron deficiency
why do you have to be careful with ferritin measurement in chronically ill patients?
ferritin is an acute phase reactant and is therefore elevated in patiens with chronic inflammation or disease
Other signs of iron deficiency in blood
serum iron falls
TIBC increases
and transferrin saturation decreases
What are two treatment options for iron deficiency and when must you give the more invasive?
oral and IV iron
must give IV iron if duodenum is not there or have IBD or gastric bypass because duodenum is where iron is absorbed
what is the importance of the placental transfusion after delivery of a baby?
it allows the blood in the placenta to transfer into the baby
what happens during last trimester for infant RBCs?
red cell mass increases a lot…
productive marrow fills the bones
LAST MONTH YOU GET 50% OF IRON STORES
higher retic count too
what is the cause of the high production of the red cells during development?
hypoxic environment so erythropoiesis is stimulated greatly
what happens when infant now breathes air with lots of oxygen?
erythropoiesis is slowed greatly so hemoglobin and reticulocyte counts drop a lot
