L1 IDA & ACD (patho) Flashcards
Iron binds to shnu that stores it until it’s needed by the body?
Ferritin
What transports iron around the body?
Transferrin
What is the most common cause of iron deficiency anemia?
Il note says Blood loss
Differentiate between the 2 types of iron
- Absorbtion
- Sources
- Their forms
- Bind to?
Which bacteria can cause iron deficiency anemia and how?
heliobacter pylori
By stealing the iron and cause gi ulcers/bleeding
What do you call RBC’s that come out in different shapes?
Poikilocytosis
What do you call RBC’s that come out in different sizes?
Anisocytosis
Anemia= low…
Low Hb, Low RBC count, Low hematocrit
Shnu hematocrit?
% blood volume
(Hematocrit is a test that measures how much of your blood is made up of red blood cells, compared to the liquid plasma)
Why can anemia cause organ dysfunction?
Bc of lack of tissue oxygenation
Clinical consequences of anemia depends on?
- Age of the patient
- The rapidity of which the anemia develops (the faster the Hb drops, the quicker the patients presents symptoms of anemia)
- Hb level
- Compensatory mechanisms of the body (heart, lungs and kidneys )
What is erythropoietin?
A hormone that the kidney makes that stimulate RBC production
T or F?
The liver produces erythropoietin
False
The kidney
How does the kidney play a part during hypoxia in the tissues?
It produces erythropoietin
Erythropoietin mechanism for regulating the rate of erythropoiesis?
Decreased production of RBC’s causes which anemias?
Nutritional deficiency anemias - Iron, B12, Folate
Increased destruction of RBC’s cause which anemia?
Hemolytic anemia
Causes of anemia?
1) Blood loss anemia
2) decreased production
3) increased destruction
What are the things that can lead to a decreased production of red blood cells?
Marrow disease (e.g. leukemia, myeloma) , malignancies, radiation
Requirements for Red Blood Cell Production?
- Erythropoietin
- AA, required for globin synthesis
- Iron
- Vit B12 & folic acid
- Vit B6
- Vit C
- Thyroid hormones, estrogens, androgens
Shlon shakl normocytic anemia?
Normal color and shape, however, low in volume
Nutritional anemias based on sizes?
- Microcytic (MCV < 80)
- Normocytic (MCV 80-100)
- Macrocytic (MCV > 100)
Deficiencies in what causes microcytic anemia?
Deficiencies in what causes normocytic anemia?
Deficiencies in what causes macrocytic anemia?
IDA is The commonest type of anemia worldwide, why is iron so important for the blood?
Iron is important for heme synthesis in hemoglobin molecules in red cells
T or F?
Non-heme iron contains more iron in its sources than heme iron
False
Veggies contain abt 2-11 mg of iron per 100, while meat in heme iron contains arnd 20
The majority of iron is found in _______ then _______ then __________
(In other words, major storage sites of RBCs)
The majority of iron is found in RBC’s then liver then the reticuloendothelial system
RBCs lifetime range
120 days
Iron absorption site?
Duodenum (duodenal cells)
Jujenum
T or F
The human ingests about 10-20 mg of iron per day from food, and all 10-20 mg of it is absorbed
False
Only 1-2 mg is absorbed
Ways iron is lost from the body?
Function of hepcidin?
Regulates iron absorption and its distribution
(high iron stores → hepcidin produced to stop iron absorption and recycling)
What produces hepcidin and when does it do that?
The liver produces hepcidin when there are high amnts of iron stores in the body
Hepcidin regulates iron via the iron exporter __________ which is found on the __________
Hepcidin regulates iron via the iron exporter ferroportin which is found on the enterocytes
⬆️ Iron = ___ Hepcidin
⬆️ Iron = ⬆️ Hepcidin
Describe the process of iron regulation in the body
(Hepcidin, ferroportin)
How does inflammation decrease iron absorption?
Because it activates Hepcidin
Things that stimulate hepcidin, and things that dont
T or F
Inflammation plays no part in iron absorption
False
It plays a huge part since it stimulates hepcidin production
Causes of IDA
- Inadequate intake
- Blood loss
- Impaired absorption
- Increased iron requirements
3a6ai examples of each
1. Inadequate intake
- low iron intake
2. Blood loss
- In GI tract (mostly due to colon cancer and bm tumors)
- In GU tract (stones)
- Bleeding disorders
3. Impaired absorption
- Gasatric surgery
- intestinal malabsorption
- celiac disease (inflammation, destruction of duodenal cells)
4. Increased iron requirements
- pregnancy and lactation
Symptoms of IDA
• Tiredness (fatigue)
• Dyspnea on exertion
↳ The patient says he didn’t experience this before, i.e. he used to take 2/3 flights of stairs, now he gets tired by 1 flight
• Headaches
• Palpitations
Why do ppl with IDA experience palpitations?
The body is trying to compensate for low, hemoglobin and oxygen
Clinical features of iron deficiency anemia?
- Brittle nails
- Angular stomatitis (that stuff arnd the lips)
- Pica (tshtheen weird stuff)
- koilonychia (flattened nails)
- Glossitis
- Platonychia (nafs 4)
- Pallor
Diagnosis of IDA
Oral therapy of IDA is usually
Ferrous sulfate
Never give blood transfusions to patients with IDA UNLESS…
The heart is compromised
“Some chronic diseases can be the cause of IDA”
How?
Patients with diabetes/chronic renal failure presents with anemia, what is the cause?
⬇️ erythropoietin production
Keyword: diabetes/chronic renal failure
Anemia of chronic disease develops in response to
___________ or _________
Anemia of chronic disease develops in response to
systemic illness or inflammation
Anemia of chronic disease is the commonest cause of anemia among patients with?
chronic illness/ diseases.
Shkthr il reduction of Hb in ACD?
Patients typically present with mild (> 100 g/L) or
moderate (85–100 g/L) reduction in hemoglobin
concentration.
Pathophysiology of ACD?
(Il cytokine w dorhom ib the cause of ACD)
Serum hepcidin test results difference between IDA & ACD
It is raised in ACD, yet low in IDA
bc of inflammation
Ferritin test results difference between IDA & ACD
(Most imp test)
Low in IDA, yet normal/high in ACD
The best laboratory indicator of body iron stores is the ________ level
The best laboratory indicator of body iron stores is the serum ferritin level
Shlon ferritin y6la3 high ib ACD?
Inflammation ygazrha 3laich, yrafi3 il ferritin fa 7sbalich 3ndich wayed iron stores bas you dont
Management of ACD
Erythropoiesis-Stimulating Agents (ESAs)
