L1 IDA & ACD (patho)

Question 1

Iron binds to shnu that stores it until it’s needed by the body?

Answer 1

Ferritin

Question 2

What transports iron around the body?

Answer 2

Transferrin

Question 3

What is the most common cause of iron deficiency anemia?

Answer 3

Il note says Blood loss

Question 4

Differentiate between the 2 types of iron

1. Absorbtion
2. Sources
3. Their forms
4. Bind to?

Answer 4

Question 5

Which bacteria can cause iron deficiency anemia and how?

Answer 5

heliobacter pylori

By stealing the iron and cause gi ulcers/bleeding

Question 6

What do you call RBC’s that come out in different shapes?

Answer 6

Poikilocytosis

Question 7

What do you call RBC’s that come out in different sizes?

Answer 7

Anisocytosis

Question 8

Anemia= low…

Answer 8

Low Hb, Low RBC count, Low hematocrit

Question 9

Shnu hematocrit?

Answer 9

% 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)

Question 10

Why can anemia cause organ dysfunction?

Answer 10

Bc of lack of tissue oxygenation

Question 11

Clinical consequences of anemia depends on?

Answer 11

1. Age of the patient
2. The rapidity of which the anemia develops (the faster the Hb drops, the quicker the patients presents symptoms of anemia)
3. Hb level
4. Compensatory mechanisms of the body (heart, lungs and kidneys )

Question 12

What is erythropoietin?

Answer 12

A hormone that the kidney makes that stimulate RBC production

Question 13

T or F?

The liver produces erythropoietin

Answer 13

False

The kidney

Question 14

How does the kidney play a part during hypoxia in the tissues?

Answer 14

It produces erythropoietin

Question 15

Erythropoietin mechanism for regulating the rate of erythropoiesis?

Answer 15

Question 16

Decreased production of RBC’s causes which anemias?

Answer 16

Nutritional deficiency anemias - Iron, B12, Folate

Question 17

Increased destruction of RBC’s cause which anemia?

Answer 17

Hemolytic anemia

Question 18

Causes of anemia?

Answer 18

1) Blood loss anemia
2) decreased production
3) increased destruction

Question 19

What are the things that can lead to a decreased production of red blood cells?

Answer 19

Marrow disease (e.g. leukemia, myeloma) , malignancies, radiation

Question 20

Requirements for Red Blood Cell Production?

Answer 20

1. Erythropoietin
2. AA, required for globin synthesis
3. Iron
4. Vit B12 & folic acid
5. Vit B6
6. Vit C
7. Thyroid hormones, estrogens, androgens

Question 21

Shlon shakl normocytic anemia?

Answer 21

Normal color and shape, however, low in volume

Question 22

Nutritional anemias based on sizes?

Answer 22

1. Microcytic (MCV < 80)
2. Normocytic (MCV 80-100)
3. Macrocytic (MCV > 100)

Question 23

Deficiencies in what causes microcytic anemia?

Answer 23

Question 24

Deficiencies in what causes normocytic anemia?

Answer 24

Question 25

Deficiencies in what causes **macrocytic** anemia?

Answer 25

Question 26

IDA is The commonest type of anemia worldwide, why is iron so important for the blood?

Answer 26

Iron is important for heme synthesis in hemoglobin molecules in red cells

Question 27

T or F? Non-heme iron contains more iron in its sources than heme iron

Answer 27

False Veggies contain abt 2-11 mg of iron per 100, while meat in heme iron contains arnd 20

Question 28

The majority of iron is found in _______ then _______ then __________ (In other words, major storage sites of RBCs)

Answer 28

The majority of iron is found in **RBC’s** then **liver** then the **reticuloendothelial system**

Question 29

RBCs lifetime range

Answer 29

120 days

Question 30

Iron absorption site?

Answer 30

Duodenum (duodenal cells) Jujenum

Question 31

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

Answer 31

False Only 1-2 mg is absorbed

Question 32

Ways iron is lost from the body?

Answer 32

Question 33

Function of hepcidin?

Answer 33

Regulates iron absorption and its distribution *(high iron stores → hepcidin produced to stop iron absorption and recycling)*

Question 34

What produces hepcidin and when does it do that?

Answer 34

The **liver** produces hepcidin when there are **high amnts of iron** stores in the body

Question 35

Hepcidin regulates iron via the iron exporter __________ which is found on the __________

Answer 35

Hepcidin regulates iron via the iron exporter **ferroportin** which is found on the **enterocytes**

Question 36

⬆️ Iron = ___ Hepcidin

Answer 36

⬆️ Iron = ⬆️ Hepcidin

Question 37

Describe the process of iron regulation in the body (Hepcidin, ferroportin)

Answer 37

Question 38

How does inflammation decrease iron absorption?

Answer 38

Because it activates Hepcidin

Question 39

Things that stimulate hepcidin, and things that dont

Answer 39

Question 40

T or F Inflammation plays no part in iron absorption

Answer 40

**False** It plays a huge part since it stimulates hepcidin production

Question 41

**Causes of IDA** 1. Inadequate intake 2. Blood loss 3. Impaired absorption 4. Increased iron requirements 3a6ai examples of each

Answer 41

**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

Question 42

Symptoms of IDA

Answer 42

• 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

Question 43

Why do ppl with IDA experience palpitations?

Answer 43

The body is trying to compensate for low, hemoglobin and oxygen

Question 44

Clinical features of iron deficiency anemia?

Answer 44

1. Brittle nails 2. Angular stomatitis *(that stuff arnd the lips)* 3. Pica *(tshtheen weird stuff)* 4. koilonychia *(flattened nails)* 5. Glossitis 6. Platonychia *(nafs 4)* 7. Pallor

Question 45

Diagnosis of IDA

Answer 45

Question 46

Oral therapy of IDA is usually

Answer 46

Ferrous sulfate

Question 47

Never give blood transfusions to patients with IDA UNLESS…

Answer 47

The heart is compromised

Question 48

“Some chronic diseases can be the cause of IDA” How?

Answer 48

Question 49

Patients with diabetes/chronic renal failure presents with anemia, what is the cause?

Answer 49

**⬇️ erythropoietin production** Keyword: diabetes/chronic renal failure

Question 50

Anemia of chronic disease develops in response to ___________ or _________

Answer 50

Anemia of chronic disease develops in response to **systemic illness** or **inflammation**

Question 51

Anemia of chronic disease is the commonest cause of anemia among patients with?

Answer 51

**chronic illness/ diseases.**

Question 52

Shkthr il reduction of Hb in ACD?

Answer 52

Patients typically present with **mild** (> 100 g/L) or **moderate** (85–100 g/L) reduction in hemoglobin concentration.

Question 53

Pathophysiology of ACD? (Il cytokine w dorhom ib the cause of ACD)

Answer 53

Question 54

Serum hepcidin test results difference between IDA & ACD

Answer 54

It is raised in ACD, yet low in IDA *bc of inflammation*

Question 55

Ferritin test results difference between IDA & ACD (Most imp test)

Answer 55

Low in IDA, yet normal/high in ACD

Question 56

The best laboratory indicator of body iron stores is the ________ level

Answer 56

The best laboratory indicator of body iron stores is the **serum ferritin** level

Question 57

Shlon ferritin y6la3 high ib ACD?

Answer 57

Inflammation ygazrha 3laich, yrafi3 il ferritin fa 7sbalich 3ndich wayed iron stores bas you dont

Question 58

Management of ACD

Answer 58

Erythropoiesis-Stimulating Agents (ESAs)