Nutritional Anemias

Question 1

What are the functions of Fe?

Answer 1

to transfer O2 as part of the heme group

Question 2

___ transports O2 to tissues within the blood, has ___ heme protein(s)
___ transports O2 to muscles for storage, has ___ heme protein(s)

Answer 2

hemoglobin/multiple

myoglobin/one

Question 3

Fe___ (___): heme, makes up 40% from ___ sources

Fe___ (___): nonhdme, all ___ sources and 60% of ___ sources

Answer 3

2+/ferrous/animal

3+/ferric/plant/animal

Question 4

Fe pathway: Fe from ___ travels to the ___ cells in the intestine for storage (called ___ ___). If we need Fe it is released from ___ to ___ so it can travel through the body. If we don’t need Fe it is ___ in intestinal cells

Answer 4

food/mucosal/mucosal ferritin/ferritin/transferrin/shed

Question 5

Ferritin:

Answer 5

storage PRO in bone marrow, liver, and spleen

Question 6

Hemosiderin:

Answer 6

storage PRO in liver and bone marrow

Question 7

Hepcidin:

Answer 7

regulating PRO in liver for maintaining Fe balance, inhibits release

Question 8

Transferrin is usually ___ saturated with Fe, low saturation indicated Fe ___ and high saturation indicated Fe ___. The ___ of transferrin is highly regulated, it ___ in adequate Fe environment and ___ in Fe-rich environments

Answer 8

1/3
deficiency/overload
number/increases
decreases

Question 9

___ indicated Fe storage levels; 1 ug ___/L___=___mg stored Fe

Answer 9

plasma ferritin/ferritin/plasma/10

Question 10

Basal daily Fe losses:

Answer 10

men: 1.0mg

premenopausal women: 1.4mg

Question 11

Where is Fe lost from?

Answer 11

menstruation, GI, skin cells, sweat, urine

Question 12

Fe balance is regulated by:

Answer 12

intake, bioavailability, absorption, storage amounts, rate of erythrocyte production, and losses

Question 13

In times of deficiency ___ efficiency is increases, Fe is ___ from intestinal cells, ___ synthesis and receptors are increased, and ___ synthesis is decreased

Answer 13

absorption/released/transferrin/ferritin

Question 14

What are the stages of deficiency?

Answer 14

1. depletion of stores
2. change in Fe transport
3. defective erythropoiesis
4. anemia develops

Question 15

Signs of an Fe deficiency anemia:

Answer 15

tiredness, parlour, decreased work performance, decreased mental productivity, decreases psychomotor and intellectual development (childhood), pica, increased lead poisoning susceptibility

Question 16

Fe deficiency anemia:

Answer 16

microcytic, hypo-chromic erythrocytes (smaller, paler red blood cells), decreased hemoglobin

Question 17

Foods high in Fe:

Answer 17

parsley, beef liver, canned clams, tomato juice, broccoli

Question 18

Fe RDA:

Answer 18

men: 8mg/day (if vegan 14mg/day)
women: 18mg/day (if vegan 33mg/day)
pregnant: 27mg/day

Question 19

Fe UL:

What does toxicity cause?

Answer 19

45mg/day

- hemosiderosis and cirrhosis

Question 20

Hemochromatosis:

Answer 20

chronic Fe overload, Fe builds up in joints and organs, potentially fatal, genetic

Question 21

Vit. B12:

Answer 21

cobalamin; responsible for methionine regeneration, synthesis of RNA/DNA, protecting nerve fibres, bone cell activity

Question 22

Good food sources of vit. B12

Answer 22

animal products (fish, meat, milk, eggs)

Question 23

B12 RDA:

B12 UL:

Answer 23

2.4ug

none

Question 24

Symptoms of B12 deficiency:

Answer 24

fatigue, dementia, peripheral nerve degeneration

Question 25

Folate:

Answer 25

folic acid/folacin; activates vitamin B12 for methionine regeneration and RNA/DNA synthesis, naturally occurs as poly-glutamate but can also be as mono-glutamate

Question 26

How does folate activate B12?

Answer 26

In the intestine glutamates are broken off folate and methyls are added. It is then delivered to cells in this inactive form. B12 removes the methyl which activated both B12 and folate

Question 27

Megaloblastic anemia:

Answer 27

lack of dietary folate or B12, causes large, immature RBC

Question 28

Pernicious anemia:

Answer 28

secondary B12-linked deficiency, intrinsic factor is deficient which causes large, immature RBC and a neurological component, supplements of B12 don’t work to fix it

Question 29

Folate deficiency:

Answer 29

impairs cell division and PRO synthesis, megaloblastic anemia, GI tract deterioration, neural tube defects, meal confusion, irritability, fatigue, elevates homocysteine/CVD risk, and drug interactions

Question 30

Spina bifida:

Answer 30

a NTD, can be prevented by taking 400ug/day folate supplements while regnant/trying to conceive

Question 31

Homocysteine:

Answer 31

damage arteries, causes CVD and strokes, can be reduces by high levels of B12 and folate (regenerates it into methionine or cysteine)

Question 32

Good food sources of folate:

Answer 32

broccoli, tomato juice, pinto beans, lentils, asparagus

Question 33

controversy about folate supplementation:

Answer 33

it can mask B12 deficiencies by fixing megaloblastic anemia which leaves the neurological problems undiagnosed

Question 34

UL of folate:

Answer 34

1000ug/day