IRON DEFICIENCY

Question 1

What are some iron containing proteins?

Answer 1

Haemoglobin
myoglobin
ribonucleotide reductase 
cyclo-oxygenase
succinate dehydrogenase 
cytochromes a,b,c
cytochrome P450
catalase

Question 2

what defines anaemia

Answer 2

low haemoglobin

which could be as a result of iron deficiency

Question 3

how is iron lost from the body?

Answer 3

Desquamated cells of skin and gut

BLEEDING - menstruation - pathological

Question 4

what does iron bind to in circulation?

Answer 4

binds to a carrier protein called transferrin

Question 5

whats is the pathogenesis of cytokines in relation to iron?

Answer 5

1. Stop erythropoietin increasing
   2. Stop iron flowing out of cells
   3. Increase production of ferritin
   4. Increase death of red cells

Question 6

what are the main causes of iron deficiency?

Answer 6

1. bleeding (most common) neg. menstruation
2. increased use eg. growth/pregnancy
3. dietary deficiency eg. vegan
4. malabsorption eg. coeliac

Question 7

what are the full GI investigations?

Answer 7

Upper GI endoscopy - oesophagus, stomach, duodenum

Take duodenal biopsy

Colonoscopy

IF FIND NOTHING
- small bowel meal and follow through

Question 8

when would you carry out full GI investigations?

Answer 8

if the patient has a good diet and no coeliac antibodies

Question 9

what are 3 common causes of low MCV

Answer 9

iron deficiency

thalassaemia trait

anaemia of chronic disease (MCV can be low or normal)

Question 10

what are the laboratory parameters needed for diagnostics

Answer 10

MCV (mean cell volume)

Serum iron
Ferritin

Transferrin

	(= total iron binding capacity, TIBC)

Transferrin saturation