Nutritional Anemia Flashcards
Enum two mechanisms of anemia
Low reticulocyte count
Decreased red cell survival
Micronutrient that is deficient in microcytic anemia
Iron
Condition of microcytic anemia that is secondary to globin chains
Thalassemia
Condition of macrocytic anemia that is secondary to bone marrow disorders
Myelodysplasia
Micronutrients that are deficient in macrocytic anemia
VitB12
Folate
Anemia depicting decrease in all blood cell lines. Including RBC.
Normocytic
What supplement do doctors give aside fr vitamins, when anemia cause is unk?
Ferrosulfate
Transport form of iron going to peripheral tissues
Blood transferrin
Stored forms of iron at body. Enumerate.
Ferritin
Hemosiderin
Iron store at blood:how many grams?
2.5
Circulating heme store at blood:how many grams? Give range.
2-2.5
Myoglobin, heme in cytochrome, ferrosome for complexes- store at blood:how many grams?
~ 0.3 grams
Lab tests done to test anemia: enumerate
CBC with differential
Peripheral smears
Reticulocyte count
80% of body’s iron is fr what system?
Reticulocyte endothelial system
Most readily absorbed form of iron
Heme iron
Vegetarians have 50% reduced Fe absorbe due to these two substances in certain vegetables
Phytate and phosphate
Vitamin that increases absorbed iron fr plants
Vit C
Which is not a sign of iron deficiency? A.spooning of nails B.conjunctival pallor C.cheilosis D.lack of clotting factors
D
Extremely high hemoglobin and hematocrit.usually seen in high altitude areas
Polycythemia vera
Anemia that is Due to impaired DNA synthesis + lower cell div. leading to larger RBC
Megaloblastic anemia
Receptor for attachment in salivary fluid; for VitB12 absorption
R-binder
What splits R-B12 to form IF-B12
Protease
IF factor receptor is in the __, and it is for attachment
Ileum
Which cells in the stomach produce intrinsic factor?
Gastric parietal cells
Which is not a consequence of Cobalamin Deficiency?
A. Too much IF
B. Mucosal cells problem
C. Autoinmune disease vs parietal cells
A
Too little dapat
Test measuring B12 deficiency, detect abnormal results in patients with genetic defect
Schilling test
Which has more severe GI manif?
A. Folate deficiency
B. Vit B12 deficiency
C. Equal
A
Which does not happen due to folate deficiency? A. Severe neuro abnormalities B. Hyposegmented neutrophils C. Increase in mean cell volume D. Decrease in hemoglobin
B
Hyper dapat
Folate draws away B12 from neurologic system for RBC Prod. T or F?
T
Diagnostic test for folate deficiency
Detect via RBC Folate
Number of RBC/oxygen-carrying capacity is insuff for physio needs. What is this?
Anemia
how much can females lose in terms of Fe @ menstrual period? give range
4-37mg/menstrual
cycle
Fe absorption takes place in the mucosa of the __
proximal small intestine
3 CAUSES OF IRON DEFICIENCY - ENUM
- Increased demand for iron and/or hematopoiesis
- Increased iron losses
- Decreased iron intake or absorption
Treatment of Iron Deficiency: enum 3 methods
RBC transfusion (for blood loss)
Oral Iron Therapy
Parenteral Iron
Enumerate three substances used for oral iron therapy
ferrous sulfate
ferrous fumarate
ferrous gluconate
this parasite is involved in competition for cobalamin
Diphyllobothrium latum
false about pernicious anemia A.most common cause of cobalamin deficiency B.caused by the absence of IF C.atrophy of mucosa D.autoimmune destruction of chief cells
D
parietal dapat
False about Stage 1 of Schilling test
A.oral dose of radiolabeled cobalamin given
simultaneously with an IM injection unlabeled
cobalamin
B.amount of radiolabeled activity is measured in feces
C.normal: > 7%
B
urine dapat
false about Schilling test, Stage 2
A. if Stage 1 is abnormal, then test is repeated following
60 mg of oral IF
B. if the level of urinary radiolabeled B12 normalizes,
then this indicates microcytic anemia
B
False about Schilling test, Stage 3
A. large intestine bacterial overgrowth may cause B12
malabsorption
B. small intestine bacterial overgrowth may be due to abnormal result in Stage 1 that
is not corrected with IF administration in Stage 2
C. broad spectrum antibiotics are given for one week to
eliminate intestinal bacteria
A
small dapat
False about Schilling test,Stage 4
A. if pancreatic insufficiency exists, B12 malabsorption
may occur
B. normalization after pancreatic enzyme therapy
suggests pancreatic origin
C. Both are true
C
sprue - medical condition that causes \_\_ malabsorption A.folate B.vit B12 C.iron D.Vit A
A
phenytoin, barbiturates, ethanol cause \_\_ malabsorption A.folate B.vit B12 C.iron D.Vit A
A
in folate deficiency, what is formed first?
A.macroovalocytes
B.hypersegmented neutrophils
C.they are formed at the same time
B
@ FOLATE DEFICIENCY: peripheral blood and bone marrow biopsy look exactly like B12 deficiency. What is usually seen?
PMN, large RBC
