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Nutritional disorders > Iron Metabolism & Disorders > Flashcards

Iron Metabolism & Disorders Flashcards

1
Q

Total body iron in the body

A

4g

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2
Q

Distribution of iron in the body (in mg)

A
  • 2500 mg in the RBCs
  • 500 mg in macrophages
  • 500 mg in liver
  • 500 mg in muscle
  • Total 4000mg = 4g
  • 4mg iron circulates in the plasma (= 0.1% of total body iron)

(all the values are approximate)

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3
Q

Distribution of iron in the body (in percentage)

A
  • 70% = Haemoglobin (the majority)
  • 25% = Ferritin and hemosiderin
  • 4% = Myoglobin
  • 0.1% = Plasma iron
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4
Q

Site of absorption

A

upper small intestine

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5
Q

Amount of absorption

A

About 10-15% of dietary iron is absorbed (regulated according to body’s need)

From intake of 6mg (per 1000Kcal) of dietary iron >>>> 15% is bioavailable

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6
Q

Chemical form of iron absorption

A

Fe2+ form from the gut

Fe2+ (ferrous) (present in gut) >>>> much better absorbed >>>> than Fe3+ (ferric) (present in blood)

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7
Q

Iron absorption is increased by-?

A
  • Vitamin-C
  • Gastric acid
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8
Q

Iron absorption in reduced by-?

A
  • PPIs (Reduced HCL)
  • Gastric achlorhydria (NO HCL)
  • Tannin (in tea)
  • Tetracycline
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9
Q

Transport of iron

A

From the gut >> Fe2+ enters the intestinal wall cell >>> In the intestinal wall, Fe2+ (ferrous) >> oxidation (by caeruloplasmin) >> Fe3+ (Ferric) >> enters blood >>> Fe3+ binds to transferrin >> transported throughout the body

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10
Q

Storage of iron

A
  • In tissues, as ‘Ferittin’

It is a plasma protein

It is an acute phase reactant >> increased in inflammations & post-surgery

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11
Q

Excretion of iron

A

Iron (heme) of RBC >>> metabolised & re-utilised

Others >>> lost via intestinal tract (by intestinal wall desquamation) >>> 1mg/day is lost

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12
Q

What is Ferritin?

A

A plasma protein

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13
Q

What situations increase ferritin?

A
  • Inflammation
  • Infection
  • Malignancy
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14
Q

Anaemias with low MCV

A
  • IDA
  • Thalassemia
  • Chronic haemolytic anaemia
  • Sideroblastic anaemia
  • Anaemia due to chronic disease
  • Haemochromatosis
  • Pregnancy
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15
Q

Iron profile of IDA

A
  • Serum iron: Low
  • Serum ferritin: Low
  • TIBC: High
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16
Q

Iron profile of thalassaemia

A
  • Serum iron: high
  • Serum ferritin: high
  • TIBC: Low
17
Q

Iron profile of chronic haemolysis

A
  • Serum iron: high
  • Serum ferritin: high
  • TIBC: Low
18
Q

Iron profile of sideroblastic anaemia

A
  • Serum iron: High
  • Serum ferritin: High
  • TIBC: Normal (Sometimes low)
19
Q

Iron profile of anaemia due to chronic diseases

A
  • Serum iron: Low
  • Serum ferritin: High
  • TIBC: Low
20
Q

Iron profile of haemochromatosis

A
  • Serum iron: High
  • Serum Ferritin: High
  • TIBC: Low
21
Q

Similarities of iron profile in thalassaemia, chronic haemolysis and haemachromatosis

A
  • Serum iron: High
  • Serum ferritin: High
  • TIBC: Low
22
Q

Structure of transferrin

A

Glycoprotein (Glucose + Protein)

23
Q

Function of transferrin

A

carries ferric iron & helps in internal iron exchange

24
Q

Transferrin level is increased by-?

A

IDA

Pregnancy

COCP

25
Q

Transferrin level is reduced by-?

A

Haemochromatosis

26
Q

How to calculate transferrin saturation in percentage?

A

(Plasma iron / TIBC) x 100

27
Q

Normal transferrin saturation

A

33%

In absence of anaemia, 33% of transferrin remains saturated

28
Q

Use of transferrin saturation

A

to measure iron stores

29
Q

Transferrin saturation in iron deficiency

A

Below 16%

30
Q

Relation between iron and transferrin level

A

Inversely proprotional

More iron >>>>> Low transferrin level

Less iron >>>>> More transferrin level

31
Q

Relation between iron and transferrin saturation

A

Proportional

More iron >>>>> More transferrin

Less iron >>>>> Less transferrin

32
Q

Conditions with high transferrin level

A

Iron deficiency anaemia

Pregnancy

COCP

33
Q

Conditions with low transferrin level

A

Haemochromatosis

34
Q

Conditions with high transferrin saturation

A

Haemochromatosis

35
Q

Conditions with low transferrin saturation

A

Iron deficiency anaemia (below 16%)

36
Q

Findings in haemochromatosis

A

Mucosal cells >>>>> high content + high iron saturation

Blood >>>>> Low transferrin level + High transferrin saturation

Nutritional disorders (8 decks)

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