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pathology - blood module > Iron Deficiency Anemia > Flashcards

Iron Deficiency Anemia Flashcards

1
Q

In what age and sex groups, Iron deficiency anemia is more common?

A

Toddlers
Adolescent girls
Women of childbearing age

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2
Q

Normal daily diet contains ___-___ mg of iron, most in the form of heme iron and remainder being inorganic iron.

A

10-20mg

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3
Q

About ___% of the heme iron is absorbable

A

20%

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4
Q

__-__% of the inorganic iron is absorbed

A

1-2%

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5
Q

Total body iron content is normally ___gm in women and __gm in men

A

2.5gm in women

6gm in men

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6
Q

Total body iron can be divided into?

Also tell the percentage.

A 
Functional iron (80-85%)
Storage iron (15-20%)
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7
Q

80% of the functional iron is found in _____________

A

Hemoglobin

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8
Q

What are the major sites of iron storage?

A

Liver and mononuclear phagocytes

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9
Q

Healthy females have iron stores _________ (greater/lesser) than males

A

Lesser

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10
Q

Iron is transported in plasma by _________

A

Transferrin

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11
Q

In normal individuals, transferrin is about ____(1/2 or 1/3) saturated with iron

A

1/3

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12
Q

Serum iron levels are _______

A

120 ug/ dL in men

100 ug/ dL in women

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13
Q

Erythroid precursors possess high affinity receptors for ___________ that mediate iron import through receptor mediated endocytosis

A

Transferrin

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14
Q

________is a ubiquitous protein iron complex that is found at highest level in the liver, spleen, bone marrow and skeletal muscles.

A

Ferritin

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15
Q

In the liver, iron is stored in _________(parenchymal cells/macrophages)

A

Parenchymal cells

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16
Q

In spleen and bone marrow, iron is stored in __________?

A

Macrophages

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17
Q

Hepatocyte iron is derived from _________(breakdown of red cells/plasma transferrin)

A

Plasma transferrin

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18
Q

Storage iron in macrophages is derived from __________ (breakdown of red cells/plasma transferrin

A

Breakdown of red cells

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19
Q

Intercellular ferritin is found in ________(cytosol/nucleus)

A

Cytosol

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20
Q

Partially degraded protein shells of ferritin aggregate into _________

A

Hemosiderin

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21
Q

To stain hemosiderin, we used Prussian blue stain which has _____________

A

Potassium ferrocyanide

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22
Q

In iron deficiency, serum ferritin is below ____ug/ L

A

12ug/ L

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23
Q

In iron overload, serum ferritin reaches ______ug/ L

A

5000ug/ L

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24
Q

Iron is lost ___-____mg each day through the shedding of mucosal and skin epithelial cells.

A

1-2mg

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25
Q

Luminal nonheme iron is in ____ (Fe+2/Fe+3) form and first has to be changed by ferrireductases into ____ (Fe+2/Fe+3) in order to be absorbed from proximal duodenum.

A

Fe+3

Fe+2

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26
Q

Example of ferrireductases is _______ (DMT-1/STEAP3)

A

STEAP3

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27
Q

B cytochrome is an example of __________ (iron transporter/ferrireductase)

A

ferrireductase

28
Q

Ferrous iron is transported in the enterocytes with the help of _______ (DMT1/Hepcidin)

A

DMT1 (Divalent metal transporter 1)

29
Q

Less than ____% of the dietary nonheme iron is absorbed

A

5%

30
Q

About ____% of the dietary iron that is derived from hemoglobin, myoglobin, etc is absorbed.

A

25%

31
Q

All the iron absorbed from the GIT lumen is stored as ________ in the mucosal cells or transported in the blood.

A

mucosal ferritin

32
Q

Iron is transported from mucosal cells to blood by _________ (ferroportin/hephaestin)

A

ferroportin

33
Q

The iron in Fe+2 form is reduced to Fe+3 by hephaestin or ceruloplasmin (after being transported by ferroportin) which are iron _________ (oxidases/reductases)

A

oxidases

34
Q

The ferric iron is then transported to red cell progenitors by ___________

A

transferrin

35
Q

DMT1 is also found on __________ (red cell precursors/macrophages) that mediates the uptake of functional iron.

A

red cell precursors

36
Q

Ferroportin is found on __________ (red cell precursors/macrophages)

A

macrophages

37
Q

Hepcidin is synthesized and released by the liver in response to _________ (increased/decreased) intrahepatic iron levels

A

increased

38
Q

How does hepcidin inhibit iron transfer from the enterocytes to plasma?

A

Hepcidin binds to ferroportin and causes it to be endocytosed and degraded

39
Q

By inhibiting ferroportin, what are the two things hepcidin does?

A

Stops iron absorption from the intestine

Do not let macrophages release iron

40
Q

In anemia of chronic inflammation, inflammatory mediators are released that ________ (increase/decrease) hepcidin levels

A

increase

41
Q

Increased hepcidin production in anemia of chronic disease leads to __________ (iron deficiency/iron overload)

A

iron deficiency

42
Q

Mutations in TMPRSS6 lead to ______ (high/low) levels of hepcidin

A

high

43
Q

What is the normal function of TMPRSS6?

A

TMPRSS6 normally suppresses hepcidin production when iron stores are low.

44
Q

People with mutations in TMPRSS6 _________ (respond/do not respond) to iron therapy

A

do not respond

45
Q

Hepcidin activity is ______ (low/high) in primary and secondary hemochromatosis

A

low

46
Q

Ineffective erythropoiesis, such as beta-thalassemia major and myelodysplastic syndrome, can lead to ___________ (iron deficiency anemia/secondary hemochromatosis)

A

secondary hemochromatosis

47
Q

Ineffective hematopoiesis __________ (enhances/suppresses) hepcidin production

A

suppresses; even when iron stores are high

48
Q

What are the four main causes of iron deficiency anemia?

A
  1. Increased requirement
  2. Chronic blood loss
  3. Inadequate intake
  4. Poor absorption
49
Q

To maintain normal iron levels, ___ mg should be absorbed daily and only 10-15% ingested iron is absorbed.

A

1 mg

50
Q

What dietary factors enhance the absorption of inorganic iron?

A

Ascorbic acid
Citric acid
Amino acids
Sugars

51
Q

What dietary factors inhibit the absorption of inorganic iron?

A

Tannates (found in tea)
Carbonates
Oxalates
Phosphates

52
Q

Human breast milk provides only about ____ mg/ L of iron.

A

0.3 mg/ L

53
Q

Cow’s milk has iron ______ (twice/half) as much as breast milk.

A

twice; but poor bioavailability

54
Q

Who can be the target of iron deficiency anemia due to dietary lack?

A

Teens eating junk food
Impoverished
Old age (restricted diet due to poor dentition)
Infants on milk

55
Q

Name some conditions that impair the absorption of iron.

A

Gastrectomy
Sprue
Steatorrhea
Chronic diarrhea

56
Q

How does gastrectomy impair iron absorption?

A

Decreasing acidity of the proximal duodenum

Increasing the speed with which the gut contents pass through the duodenum

57
Q

Economically deprived women having multiple closely spaced pregnancies are at risk of developing iron deficiency anemia. Why is that so?

A

The iron requirement is increased in pregnancy

58
Q

Chronic blood loss may be due to ___________ (most common)

A

gastrointestinal bleeding

59
Q

In iron deficiency anemia, we find _________ (high/low) total iron binding capacity (TIBC)

A

high

60
Q

Serum iron levels and ferritin levels are _____ (low/high) in iron deficiency anemia

A

low

61
Q

Transferrin saturation levels are ______ (high/low) in iron deficiency anemia

A

low

62
Q

_________ (Pencil cells/Bite cells) are seen in iron deficiency anemia

A

Pencil cells (poikilocytosis)

63
Q

What are the findings in the bone marrow in iron deficiency anemia?

A

Disappearance of stainable iron from macrophages in the bone marrow

64
Q

What are the findings in peripheral blood smear in iron deficiency anemia?

A

Microcytic
Hypochromic
Enlarged zone of pallor
Poikilocytosis (pencil cells)

65
Q

What are the signs and symptoms of iron deficiency anemia when depletion of iron containing enzymes in the cells of the body?

A

Koilonychia
Alopecia
Atrophic changes in the tongue and gastric mucosa
Intestinal malabsorption

66
Q

What are the affects on central nervous system in case of iron depletion?

A

Appearance of pica

Periodical movement of limbs during sleep

67
Q

What is Plummer-Vinson syndrome?

A

Esophageal webs
Microcytic hypochromic anemia
Atrophic glossitis

pathology - blood module (20 decks)

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