Iron Metabolism And IDA Flashcards
What factors enhance iron absorption?
Acidic pH, vitamin C, simple reducing substances such as hydroquinone, lactate, pyruvate, succinate, fructose, cysteine, and sorbitol.
These factors help in the conversion and solubility of iron, making it more available for absorption.
Where is iron maximally absorbed in the gastrointestinal tract?
Duodenum and upper jejunum.
Iron absorption is less effective in the jejunum compared to the duodenum.
What are the two broad categories of diagnostic investigations in iron deficiency anemia?
Investigations to determine storage iron and investigations to determine iron supply to tissues.
Define pica in the context of iron deficiency anemia.
Appetite for bizarre food/substances such as earth, clay, ice, or starch.
List some characteristic clinical features of iron deficiency anemia.
- Glossitis
- Angular stomatitis
- Dysphagia
- Atrophic gastritis
- Dry, pale skin
- Spoon-shaped nails (koilonychia)
- Hair loss
- Splenomegaly
- Increased platelet count
What are the general symptoms of iron deficiency anemia?
- Easy fatigability
- Dizziness
- Headache
- Irritability
- Palpitation
- Heart failure
What laboratory findings indicate iron deficiency anemia?
- Blood hemoglobin concentration (↓)
- MCV (↓)
- TIBC (↑)
- Serum ferritin (↓)
- Transferrin saturation (↓)
- Marrow iron (absent)
What is the normal concentration range for serum ferritin in healthy individuals?
15-300 μg/L, being higher in men.
Values less than 12 μg/L are diagnostic of iron deficiency anemia.
True or False: Higher ferritin values in the presence of reduced storage iron suggest an acute phase reaction.
True.
What drugs or toxins inhibit hem synthesis?
- Lead
- Isoniazid
- Pyrazinamide
- Sirolimus
Name some disorders that impair hem synthesis.
- Sideroblastic anemia
- Porphyrias
- Atransferrinaemia
- Acaeruplasminaemia
- DMT-1 mutations
- STEAP3 deficiency
What are the differential diagnoses for microcytic anemias?
- Iron deficiency anemia
- Thalassemia
- Sideroblastic anemia
- Lead poisoning
- Anemia of chronic diseases (sometimes)
What does increased total iron binding capacity (TIBC) indicate?
Characteristic of iron deficiency anemia.
What is the normal range for serum iron in iron deficiency anemia?
< 50 μg/dl.
What is the significance of serum transferrin receptors in iron deficiency anemia?
Plasma concentrations reflect both the number of erythroid precursors and iron supply to the bone marrow.
Fill in the blank: Serum ferritin levels below _______ μg/L indicate iron deficiency anemia.
12
What is the sequence of events in iron deficiency anemia?
- Depletion of iron stores
- Iron stores depletion reflected by serum ferritin level
- Serum iron, TIBC, and red cell protoporphyrin remain normal until stores are depleted.
What role does hepcidin play in iron absorption?
Regulates duodenal cell iron release through its action on ferroportin.
What dietary components inhibit iron absorption?
- Phytates
- Oxalates
- Tannates (tea, coffee, chocolate)
What is the preferred treatment route for iron replacement therapy?
Oral route.
What is ferritin?
The water-soluble primary iron storage protein providing readily available iron for hemoglobin synthesis.
What is the average daily iron intake from a normal western diet?
Approximately 15 mg of iron per day.
True or False: Iron from animal sources is absorbed better than iron from plant sources.
True.
What is the primary function of ferritin in iron metabolism?
To take up or release Iron quite rapidly.
