minerals

Question 1

iron stores in body

Answer 1

hemoglobin
myoglobin
storage of excess iron:
liver
spleen 
bone marrow

Question 2

if depleted iron stores:

Answer 2

microcytic anemia

Question 3

causes of iron poisioning in children

Answer 3

infant takes iron-fortified prenatal vitamins, iron supplements if family member had anemia

Question 4

mechanism of iron poisoning

Answer 4

peroxidation of membrane lipids → cell death

generates free radicals

Question 5

symptoms of iron poisioning

Answer 5

acute: gastric bleeding (first place iron pills will settle), hematemesis + ab pain or no sx →hypovolemic shock
6hr -3 days after ingestion: metabolic acidosis (not acute vomiting = metabolic alkalosis)
2-8 wks: scarring of GI tract (free radicals generated by iron) →obstruction of GI tract

Question 6

iron protein for cellular STORAGE of iron

Answer 6

ferritin: iron-protein complex (ferric acid + appoferritin)

↑ concentration of ferritin in hepatocytes (iron bound to ferritin in liver)

Question 7

iron protein that is an acute phase reactant

Answer 7

ferritin:
↑ inflammation/infection →hepatocytes dumps ferritin into blood so ferritin can bind to unbound iron and prevent bacteria from using unbound iron

Question 8

iron protein for TRANSPORT of iron

Answer 8

transferrin:
binds ferric (Fe3+) molecules and transports in blood (iron from liver to BM, etc)
made in liver
T1/2 = 8 days

Question 9

iron protein ↑ in iron deficiency

Answer 9

transferrin: need protein to deliver more iron (high binding capacity in IDA because not much iron around for binding)

Question 10

essential for activity of 100+ enzymes
carbonic anhydrase: renal tubules, RBC
lactate dehydrogenase
immune system
form zinc fingers (transcription factor for DNA transcription - need proteins in healing state)

Answer 10

zinc

Question 11

give if healing or wound inadequate healing

Answer 11

zinc

Question 12

zinc deficiency

Answer 12

delayed wound healing
decreased wound healing
↓facial and body hair
hypogonadism
anosmia (↓ smell)
dysgeusia (↓ taste)
↓ immune response
rash: eyes, mouth, nose, anus (acrodermatitis enteropathica)
anorexia, diarrhea
growth retardation
depression
impaired night vision (like vit. A)
infertility

Question 13

most important regulator of Ca metabolism

Answer 13

PTH

Question 14

hyperparathyroidism causes

Answer 14

hypercalcemia:

STONES, BONES, GROANS, psychiatric OVERTONES

Question 15

hypocalcemia signs

Answer 15

tetany + spasms
Trousseau sign: Tighten bp cuff → carpopedal spasm
Chvostek sign: tap cheek → facial muscle spasm

Question 16

muscle contractions
NT release
platelet function
clotting cascade
intracellular processing: need for glucose, ATP

Answer 16

calcium

Question 17

lead poisioning

Answer 17

acute: ↓ IQ, hearing problems, growth impairment, peripheral neuropathy (wrist drop and foot drop), lead lines (interferes with remodeling of cartilage in growing bones, can get in teeth and gum junctions = burton lines)
severe: ↓ hemoglobin synthesis → anemia, abdominal pain (lead inhibits ferrochelatase + ALA dehydratase), nephropathy, encephalopathy, death

Question 18

wrist drop and foot drop

Answer 18

lead poisioning

Question 19

basophilic stippling

Answer 19

lead poisioning

lead inhibits rRNA degradation → retain rRNA segmetns in RBC

Question 20

ringed sideroblasts in BM

Answer 20

lead poisioning

RBC precursor that contains mitochondria filled with iron

Question 21

treatment of lead poisioning

Answer 21

mild: remove source
mod-high with sx in adult/child: chelating agent (succimer or EDTA)
child with severe: dimercaprol +/- succimer

Question 22

mercury poisioning

Answer 22

shark, swordfish, tilefish, king mackerel (avoid these fish in pregnancy), old thermometer, batteries
accumulates in KIDNEYS + BRAIN→ enlarged kidneys, peripheral neuropathy, tremor, pscyh: excitability, insomnia
acrodynia: peeling of finger tips
abdominal pain

Question 23

2 molecules iron is bound in human cells vs blood

Answer 23

cells: myoglobin, ferritin
blood: hemoglobin, transferrin