Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 MCD Haematology > Iron Deficiency > Flashcards

Iron Deficiency Flashcards

1
Q

What is the role of iron in erythropoiesis?

A

Iron is the central molecule of the Ham-groub of haemoglobin

–> - holds onto oxygen –> can be curicial if very deficient!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does a low iron level lead to?

A

Low iron= low Hb= Anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Explain the needed levels of iron for erythropoiesis and the required dietary intake

A
  • because of relatively short lifespan of erythrocytes (120 days)–> many are made new every day
  • –> need of 20 mg/day for production
  • but mainly recycled so need is 1-2 mg/day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the main sources of iron in human diet?

A
  • Meat and fish (haem iron) –> easier reabsorbed
  • Vegetables
  • Whole grain cereal
  • chocolate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which form of iron is absorbed?

Which agents might help with this?

A

Only Fe2+ is absorbed in small intestine (not Fe3+)

–> enhanced by Vit C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which factors influence iron absobtion ?

A
  • DIET:
    • increase in haem iron
    • ferrous iron
  • INTESTINE:
    • acid levels in (duodenum)
    • ligand (meat)
  • SYSTEMIC:
    • iron deficiency
    • anaemia/hypoxia
    • pregnancy
      • all systemic enhance iron uptake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How it iron absorbtion in the gut regulated?

A

Hepsidin inhibits ferroportin –> iron absorbtion into the blood stream

Hepsidin is produced at high iron levels

–> at high levels of iron –> low reabsorbtion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the role of transferrin?

A

Molecule that binds iron in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which three clinical test can you perform looking at the transferrin?

A
  1. Transferrin
  2. Total iron binding capacity, TIBC (basically is transferrin levels)
  3. Transferrin saturation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the cause of anaemia of chronic disease?

A

It is essentially an “iron deficiency problem” (iron is not available for production) –> but only problem is that patients are physically unfit (no malabsorbtion, no bleeding, no malignancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the laboratory signs of someone with anaemia of chronic disease (not the haematology lab

A
  1. increase in C-reactive protein
  2. increase in Erythrocyte Sedimentation Rate
  3. increase in Acute phase response molecules
    • ferritin
    • FVIII
    • fibrinogen
    • immunoglobulins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In which associated conditions does an anaemia of chronic disease occur?

A
  1. .Chronic infections e.g. TB/HIV
  2. .Chronic inflammation e.g. RhA/SLE
  3. .Malignancy
  4. .Miscellaneous e.g. cardiac failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the underyling reason for anaemia of chronic disease?

A

Patients are physically unwell –> leading to

Cytokines

  • •Cytokines prevent the usual flow of iron from duodenum to red cells –> block in normal iron uitilisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do increased cytokine levels in anaemia of chronic diseae lead to a impaired use of iron?

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

Therefore

  • make less red cells
  • more red cells die
  • less availability of iron (stuck in cells/ferritin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the major reasons for iron deficiency?

A
  1. Bleeding (most important!) ​
    • can be menstrual/GI
  2. Increased use/demand
    • growth
    • pregnancy
  3. Dietary deficiency (vegetarian)
  4. Malabsorbtion
    • coeliac
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How would you investigate a man or a post-menopausal woman with an iron-deficiency?

A
  • Ask for diet –> if normal
  • Coeliac antibody test –> if negative
  • GI investigations (for chronic bleeding)
    • colonoscopy
    • endoscopy
    • duodenal biopsy
    • if nothing found: small bowel meal and follow through (camera)
  • Urinary blood loss, heavy periods
17
Q

How would a typical patient with an iron deficiency present: Hb, MCV. iron, ferritin, transferrin and transgferrin saturation

A
  • low Hb
  • low MCV
  • low serum iron
  • low ferritin (iron storage)
  • high transferrin
  • low transferrin saturation

–> everything is low!

18
Q

What is the differential diagnosis in someone with a low MCV?

A
  1. iron deficiency anaemia
  2. thalassaemia trait (heterozygous)
  3. anaemia of chronic disease (MCV might also be normal)
19
Q

What are possible causes of low serum iron?

A
  • Iron deficiency
  • anaemia of chronic disease (=no effective use of iron)
20
Q

How would serum iron levels look like in someone with thalassaemia?

A

Normal

21
Q

What is ferritin?

A

Iron storage protein

22
Q

How would ferritin levels look like in

  1. iron deficiency
  2. anaemia of chornic disease?
A
  1. Iron deficiency
    1. low
  2. Anaemia of chronic disease
    1. normal or
    2. high –> ferritin is an accute phase protein
23
Q

How can a patient be iron deficient but have a normal ferritin level?

A

If he has both, iron deficiency anaemia and anaemia of chronic disease –>

  1. Iron levels might be low but
  2. Ferritin is high due to acute phase response in anaemia of chronic disease
24
Q

How would transferrin levels in someone with

  1. iron deficiency
  2. anaemia of chronic disease look like?
A
  1. Iron deficiency
    1. increased
  2. anaemia of chronic disease
    1. low – >(ususally low due to problems with protein production)
25
Q

How would the transferrin satureation look like in someone with

  1. iron deficiency anaemia
  2. anaemia of chronic disease
A
  1. Low
  2. normal
26
Q

How would someone with anaemia of chrnic disease ususally present regarding their

  1. Hb
  2. MCV
  3. Serum iron
  4. Ferritin
  5. Transferrin
  6. Transferrin saturation
A
  1. low Hb
  2. low MCV
  3. low Serum iron
  4. normal/high ferritin (aqute phase response)
  5. normal/low transferrin (inability to produce proteins)
  6. normal transferrin staturation
27
Q

How would you confirm a thalassaemia trait?

A

Via erythrocyte electrophoresis

+ lab results

  • might be low Hb
  • might be low MCV
  • everything else normal
28
Q

How would you manage someone with iron deficiency?

A

Normally oral iron replacement

29
Q

Explain the absorbtion of iron in the small intestine

A

Normally absorbed in the duodenum

  1. Uptake in 2+ form
  2. Converted to Ferritin in cell
  3. Via transporter Ferroportin into blood stream
  4. Bound to Transferrin in blood
30
Q

Explain the appearance of the blood film of someone with iron deficiency

A

Microcytic

Hypochromic

enlarged central pallet

can have shape distortion

Year 2 MCD Haematology (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions