Nutritional Anemia Flashcards
Diff between iron depletion, defient erythropoesis, deficency anemia:
- Depletion: from stores only
- Erythropoesis: low seum iron decrease and TIBC increase, no change in Hb
- IDA: Hb low hypochromic microcytic
What is iron absorption enhanced by?
- breast milk
- asorbic acid
What is iron absorption decreased with?
- cow milk
- tea (green tea or red tea)
- phytate & phosphate
- egg yolk
Most common site for iron storage is:
RBC
What is the role of hepicidin
(Binding with ferroportein)
- inhibits intestinal absorption of iron
- inhibits iron release from (liver - macrophage)
What are the causes of iron def anemia:
- decrease intake (most comon)
- increase loss\blood loss
- increase demand
- decrease functional availibity (IRIDA)
- decrease absorption
What is the mutation in the IRIDA (iron refractory iron deficiency anemia)
TMPRSS6
What are the physiological adapation of anemia?
- shift to the right (decrease o2 affinity)
- increased HR\SV
- vasodilation
What are the CBC findings in IDA?
Low Hb, Hct, MCV,
High RDw High platelet
What are the findings of iron profile in IDA?
- low serum iron
- low ferritin
- high TIBC
- high transferrin
Which parameter in IDA not affected by acute inflammation that could be accurate?
Transferrin
Best to use it
What is the best diagnostic study of IDA?
Rsolution of anemia following a trial of Iron supplement
What are the findings of the blood profile in Folate and b12 (similaritis)
- neutrophils: low & hyper-segmented
- platelet: low (mild)
Where’s the absorption of B12 and folate
- b12: terminal ileum
- folate: duodenum and upper small intestine
What increasees if there’s reduced B12 in contrast to folate
- methylmalonic acid - homocystine
- homocystine
why is homoscystine elevated in both b12 and folate
To convert homocystine to methionine
We need to convert methyl tetra hydrofolate “diatery” to tretrohydrofolate (Which can only be done with B12)
What are the findiings of transcoblamin def?
Normal vitamin B12 levels in the blood
With signs of b12 anemia (b12 can’t enter the cells\BM)
What are the causes of vitamin B12 def?
- decreased intake
- decreased absorption
- malabsorption (despite IF)
- increased utilization
- transcoblamin def.
What causes reduced intake of b12
Vegan\breast fed vegans
What is juvenile pernisous anemia
Abscence of IF
What causes Malabsorption despite normal intrinsic factor
- resection of ileus
- IBD
- imerslund-grasbeck syndrome (receptor in terminal ileum)
What infection could cause increased utilization of intestinal Vitamin b12
Fish tapeworm
What are the causes of folate def
1- decreased intake
2- malabsorption
3- increased demand
4- medics
Name an examaple of decrease intake of folate in pedia
Malnutrition, prematurity, goat milk
