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Iron Deficiency Anaemia Flashcards

1
Q

Ferrous

A

Fe2+

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2
Q

Ferric

A

Fe3+

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3
Q

Iron is absorbed at the

A

Duodenum

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4
Q

Apical side of duodenum:

Duodenal cytochrome B (DcytB) function?

A

Reduces Fe3+ to Fe2+ at apical membrane of enterocytes

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5
Q

Divalent metal transporter (DMT1) function on apical side of duodenum?

A

Transports non-haem Fe2+ across apical membrane

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6
Q

Heme on apical side is from ?

A

Red meat

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7
Q

Heme and ferritin is absorbed in duodenum’s apical side via?

A

Unknown transporters

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8
Q

Enterocyte: Hemeoxydase1 (HO-1) function?

A

Removes Fe2+ from heme

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9
Q

Basal side: ferroportin function?

A

Transports Fe2+ on basal side to plasma

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10
Q

Basal side: hephaestin function?

A

Oxidizes Fe2+ to Fe3+ at basal membrane

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11
Q

Basal side: transferrin function?

A

Transports iron in blood

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12
Q

Iron donation to plasma: macrophage phagocytizes?

A

RBC

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13
Q

Iron donation to plasma: ferroportin function?

A

Transports Fe2+ into blood

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14
Q

Ceruloplasmin function in iron donation to plasma?

A

Oxidizes Fe2+ to Fe3+ in blood

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15
Q

Iron donation to plasma: transferrin function?

A

Transferrin binds Fe3+

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16
Q

Describe iron uptake by cells:

A
  1. Diferric transferrin endocytosed
  2. Acid pumped into endosome to remove Fe3+
  3. STREAP3 reduced Fe3+ to Fe2+
  4. DMT1 transfers Fe2+ into cytosol
  5. Transferrin released to plasma
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17
Q

Regulation of iron metabolism is managed by?

A

Hepcidin

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18
Q

Hepcidin is the?

A

Master controller of iron in body

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19
Q

Hepcidin is produced and released by?

A

Liver

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20
Q

How does liver detect iron-content of blood?

A

Liver has iron receptors that detect iron-content of blood

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21
Q

Function of hepcidin?

A

Binds and internalizes ferroportin on enterocytes and macrophages.
- Inhibits iron release into blood

22
Q

List the three risk factors for iron deficiency

A
  1. Increase iron requirement
  2. Limited external iron supply
  3. Blood loss
23
Q

what can increase iron requirement?

A
  1. Growth

2. Erythropoiesis-stimulating treatment

24
Q

What can cause limited external iron supply?

A
  • Poor diet/intake

- Malabsorption

25
What can cause blood loss?
- Removal of blood (e.g. donation or dialysis) | - Haemorrhage
26
Serum ferritin assay measures?
Measures amount of ferritin in blood; reflects total iron content
27
Serum iron concentration measures?
Measure serum iron concentration by denaturing transferring and adding reducing agent and colorizing agent.
28
Iron-binding capacity lab test measures?
Measures excess transferrin in serum
29
List the steps in iron-binding capacity lab test
- Measure iron content before (unsaturated iron-binding capacity (UIBC)) - Add extra iron to serum to saturate transferrin - Wash away excess - Measure iron content after (Total iron-binding capacity (TIBC))
30
Large difference in UIBC (unsaturated iron-binding capacity) and TIBC (total iron-binding capacity) means?
Iron deficiency anaemia (body makes excess transferrin when iron is low)
31
Serum transferrin assay lab test
Directly measures amount of transferrin
32
Transferrin saturation
Ratio of UIBC and TIBC
33
Low levels of ferritin
iron deficiency
34
High levels of ferritin
Iron overload
35
Low levels of serum iron
Iron deficiency
36
High levels of serum iron
Haemochromatosis (genetic disease that causes high iron absorption
37
High levels of transferrin but low saturation
Iron deficiency, but saturation is low
38
High levels of transferrin and high saturation
Iron overload
39
High level of total iron binding capacity
Iron deficiency
40
Ferritin is best indicator of?
Best indicator of body iron stores
41
List lab studies/results for iron deficiency anaemia
- Low Hb - Low transferrin saturation (<20%) - Low ferritin concentration
42
RBC indices of iron deficiency anaemia
- Low mean cell Hb concentration (i.e. hypochromasia - increased pale area of RBC) -> best indicator for irond eficiency - Use MCV for differential diagnosis
43
Low mean cell Hb concentration
Best indicator for iron deficiency
44
Blood films in iron deficiency anaemia: red cells
- Hypochromia (pale cells) - Microcytosis (small cells) - Poikilocytosis (odd shape, e.g. "pencil cells") - Target cells - Increased platelet count
45
Hypochromia
Pale red blood cells
46
Microcytosis
small red blood cells
47
Poikilocytosis
Odd shaped red blood cells (pencil shaped cells)
48
Thalassaemia Trait differential diagnosis
Low MCV but normal Hb production
49
Anaemia of chronic disease differential diagnosis
Increased red cell stacking (rouleaux) and background staining (from Ig)
50
Iron deficiency anaemia differential diagnosis
Anisochromasia (RBC shape and colour) and pencil cells

Block 3 (9 decks)

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