Nutritional Anaemias

Question 1

What is anaemia?

Answer 1

Condition where number of red blood cells are depleted affecting oxygen carrying capacity due to REDUCE HAEMOGLOBIN - insufficient to meet body’s physiologic needs

Question 2

What is haemoglobin

Answer 2

Iron containing oxygen transport metalloprotein

Question 3

What is required for erythropoeisis?

Answer 3

Vit B12
Folic acid
DNA synthesis 
Iron
Haemoglobin synthesis
Cytokines (erythropoeitin)
Healthy bone marrow environment

Question 4

What are the 3 mechanisms of action for anaemia?

Answer 4

Failure of production (not enough componets or correct bone marrow environment - hypoproliferation resulting in reticulocytopenia (low levels of reticultocytes)
Ineffective erythropoeisis (only incorrect bone environment, vitamins all present)
Decreased survival - blood loss / haemolysis = reticulocytosis (increased reticulocytes trying to compensate)

Question 5

What is MCV and the 3 types in anaemia?

Answer 5

mean cell volume

• microcytic
• normocytic
• macrocytic

Question 6

What cause microcytic anaemia? + example of condition

Answer 6

Iron deficiency - haem deficiency

• thalasemia (globin deficiency)

Question 7

What cause normocytic anaemia? + example of condition

Answer 7

Anaemia chronic disease

• sickle cell disease
• chronic renal failure
• bone marrow infiltration

Question 8

What cause macrocytic anaemia? + example of condition

Answer 8

B12 deficiency and folate deficiency

• liver disease
• drug induced
• alcohol induced

Question 9

What is nutritional anaemia?

Answer 9

Anaemia cause by lack of essential ingredients from food sources e.g iron, vit b12 and folate

Question 10

Why is iron needed for blood?

Answer 10

• essential for O2 transport

Question 11

How much iron intake is needed?

Answer 11

Daily requirement varies person to person e.g gender, child, menstruation, pregnancy

Question 12

What are the intake of diff types of iron?

Answer 12

Heme iron - less needed

non heme iron - more needed due to lower absorption

Question 13

Why is iron distribution important after absorption? and where is it distributed

Answer 13

Iron can not be selectively excreted

• muscles, liver, bone marrow, circulating erythrocytes

Question 14

How is iron utlisised after absorption?

Answer 14

Muscle to form myoglobin
Liver stores iron
Bone marrow uses to produce red blood cells and reticuloendothelial macrophages

Question 15

How is iron lost from the body?

Answer 15

Mucosal cells, desquamation/menstruation and other blood loss

Question 16

What are the different forms of iron? and where are they?

Answer 16

Stabilsied into ferric states (3+) and ferrous states (2+). rest of iron is in circulating Hb. Rest is in stoareg and transport proteins such as ferritin in liver, spleen and bone marrow

Question 17

What regulates iron absorption?

Answer 17

GI mucosal cells and HEPCIDIN

Question 18

Where is iron absorbed? and what is it taken up by and into what?

Answer 18

Duodenum and proximal jejunum via ferroportin receptors on enterocytes and transferred into plasma where it binds to transferrin (taken to wherever it needs to go)

Question 19

Which vitamin helps iron absorption?

Answer 19

Vitamin C