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CLS 307 > Lecture 9 Chapter 17 > Flashcards

Lecture 9 Chapter 17 Flashcards

1
Q

Reasons there’s increased need of iron/blood

A

Vegan
Pregnant
Heavy menstruation
Chronic loss I.e. GI bleeding
Impaired absorption due to pH levels in stomach and the intestines environment

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2
Q

What is the marrow iron rating in a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia?

A

2-3+
0-1+
0
0

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3
Q

What is the serum Fe level in a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia am?

A

150 micrograms/dL
120 micrograms/dL
<100 micrograms/dL
<20 micrograms/dL

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4
Q

What is the % saturation in a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia am?

A

40%
35%
<30%
<20%

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5
Q

What is the hematocrit % in a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia am?

A

45%
45%
41%
<40%

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6
Q

What is the RBC morphology of a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia am?

A

Normal
Normal
Normal
Microcytic hypochromic

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7
Q

What is the normal range of % saturation

A

20-55%

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8
Q

What is the morphology of RBCs in chronic anemia cases?

A

Microcytic
Hypochromic

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9
Q

Groups more at risk of iron deficiency anemia

A

Pregnant women
Vegans
Genetic
Women with heavy periods

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10
Q

Groups less at risk of iron deficiency anemia

A

Adult males

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11
Q

Factors increasing risk of iron deficiency anemia

A

Pregnant
Heavy menstruation
Age

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12
Q

Diagnostic tests for iron deficiency anemia

A

Serum iron
Total iron-binding capacity (TIBC)
Transferrin saturation
Ferritin

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13
Q

Label

A

From top down:
Unsaturated iron binding capacity (UIBC)
Total iron binding capacity (TIBC)
Serum iron (S.I.)

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14
Q

% Transferrin saturation =

A

(Serum iron concentration/TIBC)*100

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15
Q

What does free protoporphyrin bind to

A

Zinc

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16
Q

What is an acute phase reaction

A

A protein
Inflammation/infection/chronic disease effect the levels of it
They are either positive or negative

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17
Q

Examples of proteins that have a positive level or increase due to an acute phase reaction

A

Ferritin
hepcidin

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18
Q

Examples of proteins that have a negative level or decrease due to an acute phase reaction

A

Transferrin
Albumin

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19
Q

What does bacteria need to replicate

A

Ferritin/iron

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20
Q

How does your body respond to a bacterial infection

A

Your body makes more ferritin and has it bind to iron so the bacteria cannot bind and divide
Transferring goes down so you don’t transfer iron while bacteria is trying to divide

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21
Q

What happens when there is not enough iron to bind with protoporphyrin

A

The protoporphyrin will bind to zinc and levels of zinc and free protoporphyrin in the blood will increase

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22
Q

What organ produces serum transferrin receptors

A

Liver

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23
Q

Levels of serum transferrin increase when ______, and decrease when ______

A

There is not enough iron
There is too much iron

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24
Q

What test can provide a final answer or confirm a suspicion

A

Bone marrow evaluation (biopsy/aspiration)

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25
Q

Study

A
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26
Q

Describe the path of iron from a macrophage

A

Transferrin binds to iron → delivers to the bone marrow → hepcidin traps iron

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27
Q

Anemia of chronic disease is the disease of

A

Iron transportation

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28
Q

Cell morphology for anemia of chronic disease

A

Mild microcytic
Mild hypochromic

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29
Q

Causes of anemia of chronic disease

A

Chronic infections, inflammations, malignancy and anemia of renal disease

30
Q

What is the origin of anemia

A

Lack of transportation of iron, or not enough iron

31
Q

When you have an inflammation, your immune cells, _____, ______, and _______ release _____ and increases the expression of ______

A

B lymphocytes
T lymphocytes
Macrophages
Interlucin 6
Hepcidin

32
Q

Diagnosis of anemia of chronic disease based on

A

Degree of anemia
Classification of anemia (microcytic/hypochromic)
WBC and platelet counts increase
Mcv= lower end of spectrum 80-100
Iron level may be normal or in range
Serum-transferring receptors

33
Q
A

Siderocytes/ringed sideroblasts

34
Q

What color does perl’s stain make iron

A

Green/blue

35
Q

What is the cause of sideroblastic anemia

A

Iron disorder; has to do with the production of protoporphyrin

36
Q

What are pappenheimer bodies?

A

Iron deposits

37
Q

Succinyl CoA generates what

A

Porphryn

38
Q

Porphyry goes through 6-7 enzymatic cells to create

A

Protoporphryn IX

39
Q

Where does protoporphryn IX go after getting created

A

Goes to mitochondria of a normoblast and get incorporated into iron and that creates heme

40
Q

If hereditary,if there is a mutation in any of the proteins that are involved in the function of the 6 enzymes porphryn goes through to become protoporphryn IX you will develop

A

Byproducts, each having a different effect

41
Q

Porphyria’s

A

A collective group of diseases
Very heterogenous

42
Q

Pyphyrias are a

A

Neurological disorder
Cause pathological conditions
Turns urine red due to the byproduct of free metabolism
Accumulates in skin and every tissue

43
Q

What happens when you have porphyria and go into the sunlight

A

The periphery molecules absorb the UV light
Can cause blistering/burning

44
Q

With porphyria you cannot

A

Make protoporphryn IX → cannot make heme → cannot make hemoglobin → anemia → microcytic and hypotrophic

45
Q

Which anemia has to be confirmed by bone marrow

A

Sideroblastic anemia

46
Q

What is the cause of sideroblastic anemias

A

Production of protoporphryn

47
Q

If you do not have enough protoporphry….

A

Iron will deposit in normoblasts

48
Q

What is the most common material that causes an acquired sideroblastic anemia

A

Lead/heavy metal poisoning

49
Q

Characteristics of lead/heavy metal poisoning

A

Attacks nervous system/brain, permanent damage
Most common among children
Can see iron deposits with Perl stain

50
Q
A

Nucleated RBCs

51
Q

Label

A

Top to bottom:
Granules
nRBC
Siderocyte
Pappenheimer bodies

52
Q

Treatment for sideroblastic anemias

A

Remove the cause
Chelation of lead

53
Q

What is hereditary hemochromatosis

A

Iron overload due to genetics

54
Q

What is the Fenton reaction

A

Iron has a tendency of generating free radicals such as O2 and OH that bind to proteins in nucleic acids and lipids

55
Q

Free radicals damage what

A

Every organic compound in the body

56
Q

How harmful is iron overload

A

Very harmful, but can take 10-20 years to develop

57
Q

If iron deposits accumulate in your heart when you develop iron overload you will get

A

Cardiomyopathy

58
Q

If iron deposits accumulate in your pituitary glands when you develop iron overload you will get

A

Endocrine forms

59
Q

If iron deposits accumulate in your liver when you develop iron overload you will get

A

Liver cirrhosis

60
Q

If iron deposits accumulate in your kidney when you develop iron overload you will get

A

Renal failure

61
Q

What is the HFE gene

A

A gene that is mutated in various hemochromatosis

62
Q

What does it mean when your liver turns a rusty brown color

A

Hepatocytes dying

63
Q

What disease causes excessive iron accumulation in the liver from the gut due to abnormal absorption of normal iron intake resulting in organ dysfunction

A

Autosomal recessive hemochromatosis

64
Q

What disease does iron overload from any other cause such as frequent transfusions or dietary overconsumption

A

Hemosiderosis

65
Q

What does HFE protein do

A

Controls the expression of the gene for hepcidin

66
Q

Heparin expression goes

A

Up when too much iron
Down when too little iron

67
Q

What happens when you have a mutation in the HFE

A

Cannot make the right HFE protein
Cannot control process so level of hepeidin will always be down
As iron gets absorbed, the hepathocytes will induce HFE gene to produce hepcidin
Hepcidin inhibits iron absorption
Cannot make hepcidin expression go up due to mutation
So hepcidin is always off
You absorb more than 1-2mg per day

68
Q

What is an example of acquired iron overload

A

When someone needs to get blood transfusions due to an issue with their lifespan of RBCs
Transfusions contain 250mg of iron plus their diet

69
Q

If you find a mutation in the HFE gene, that tells you its what diagnoses

A

Hereditary hemochromatosis

70
Q

Hemochromatosis is _______ which means it must have _____ gene mutations

A

Autosomal recessive
2

CLS 307 (21 decks)

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