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ICC1 > iron deficiency anemia part 1 > Flashcards

iron deficiency anemia part 1 Flashcards

1
Q

what are the stages of deficiency?

A

depletion of stores
morphological abnormalities in blood film and BM
anaemia
anemia is the final expression of the deficiency state

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2
Q

how is haem synthesised ?

A

incorporation of iron into protophyrin in nucleated red cells in bone marrow

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3
Q

what are the differential diagnosis of microcytic hypochromic anemia ?

A

sideroblastic anemia
iron deficiency anemia
thalassemia
anemia of chronic disease

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4
Q

what is the average iron store in a healthy individual?

A

40-50 mg/kg

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5
Q

what form is iron stored in in RBCS?

A

haemoglobin

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6
Q

in what form is iron stored in in muscles ?

A

myoglobin

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7
Q

in what form is iron stored in in all tissues ?

A

cytochromes and iron sulphur proteins

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8
Q

in what form is iron stored in in the liver spleen and bone marrow ?

A

ferritin and haemosiderin

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9
Q

when do iron requirments increase ?

A

menustration
pregnancy
early infancy
adolescent growth spurt

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10
Q

how is iron transported ?

A

transferrin

lactoferrin in milk

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11
Q

what kind of transport is transferrin responsible for ?

A

extracellular transport

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12
Q

what is the expression of TFR in iron deficiency anemia like ?

A

cellular expression increases if cells have inadequate stores and decrease if the iron replete

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13
Q

what can differentiate between iron deficiency anemia and anaemia of chronic disease ?

A

soluble transferrin receptor , they increase as an early indicator of iron deficiency anemia but are off normal levels in anemia of chronic disease

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14
Q

what is the role of TFR-2 ?

A

senses the degree of saturation of the transferrin and is a key regulator of hepcidin synthesis

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15
Q

what is haemosidrin ?

A

partially degraded ferritin along with lysosomes

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16
Q

what are the causes of iron deficiency ?

A

limited supply
increased physiological requirements
blood loss

17
Q

what could the limited supply be due to ?

A
  • inadequate dietary iron take

- decreased iron absorption

18
Q

what are the causes of decreased iron absorption ?

A

coeliac disease

gastrectomy

19
Q

what is the occult blood test ?

A

is a test used to detect any evidence of blood in stool

20
Q

what are the clinical features of iron deficiency anemia ?

A
  • tiredness, exertional dyspnoea
  • angular stomatits
  • kolionychias
21
Q

what does the blood film in iron deficiency anemia look like ?

A

microcytic hypo chromic anemia
presence of pencil cells
target cells

low MCH MCV MCHC

22
Q

what is TIBC?

A

total iron binding capacity

23
Q

what is meant by transferrin saturation ?

A

percentage of saturation transferrin is

the serum iron divided by TIBC x 100

24
Q

what value of transfferin saturation would indicate iron deficiency anemia ?

A

15%

25
Q

what iron stain is used in bone marrow aspirate ?

A

perls prussian blue stain

26
Q

how would you correct the iron deficiency ?

A
  • oral iron supplements 200mg 3 times a day for 4-6 months ( ferrous sulphate )
  • parenteral iron
27
Q

what are the side effects of oral iron therapy ?

A

GI side effects

28
Q

what is the affection in sideroblastic anemia ?

A

iron accumulation in the RBC

29
Q

what does haemosedrin look like on film ?

A

yellow on unstained film

positive with iron stain

30
Q

what is the most common cause of chronic blood loss causing anemia ?

A

hookworm

31
Q

what type of cells are found in the film of iron deficiency anemia ?

A

pencil cells

target cells

32
Q

what are the results of iron studies in iron deficiency anemia ?

A 
low serum iron 
low transferrin levels 
low serum ferritin 
increased total iron binding capacity 
increased soluble transferrin receptor
33
Q

what is diagnostic of sideroblastic anemia in blood film ?

A

sideroblastic ring

34
Q

what is the lifespan of a RBC ?

A

120 days

35
Q

what is the relationship between hepcidin and iron ?

A

when hepcidin increases iron decreases

36
Q

what are the clues in diagnosing sideroblastic anemia ?

A

1- atypically high ferritin and iron
2- may present as iron deficiency as it shows microcytic hypochromic anemia
3- resistant to inteensive iron treatment

ICC1 (50 decks)

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