RBC Wed Prereading Flashcards

1
Q

List some major sources of iron

A

red meat, shellfish, fish-heme iron

enriched cereals, beans, tofu, seeds, potatoes, green veggies, dried fruit-non heme iron

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2
Q

When are plasma hepcidin levels high?

A

when stores are full of iron and erythropoietic activity is normal

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3
Q

What does high plasma hepcidin cuase?

A

downregulation of ferroportin and trapping of most of the absorbed iron

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4
Q

When are plasma hepcidin levels low?

A

when body iron stores are depleted or erythropoiesis is stimulated

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5
Q

What happens when hepcidin leves are low?

A

ferroportin activity increases, allowing a greater fraction of absorbed iron to be transferred into plasma transferrin

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6
Q

What protein allows for entry of non-heme iron?

A

DMT-1 divalent metal transporter 1

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7
Q

What protein allows for entry of heme?

A

heme transporter

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8
Q

What cofactor is required for the asorption of non-heme iron?

A

vitamin C

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9
Q

What enzyme reduces ferric to ferrous? What is it dependent on?

A
duodenal cytochrome B
ascorbic acid (vit C)
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10
Q

What stores iron in dueodenal cells?

A

ferritin

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11
Q

What transports ferrous across the basal later membrane of duodenal cells?

A

ferroportin 1

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12
Q

What converts ferrous back to ferric once it has crossed the basal lateral membrane?

A

hephaestin

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13
Q

What molecule transports ferric in the blood?

A

transferrin

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14
Q

How do other cells take up ferric?

A

transferrin receptor–>endocytosis–>DMT1 to get out of endosome

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15
Q

What molecule regulates the release of iron from the duodenal epithelial cells?

A

hepcidin

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16
Q

What are hemosiderin granules?

A

partially degraded ferritin-iron complexes

this is the main storage form for iron during overload

17
Q

How is iron recycled?

A

by marophages

18
Q

What are major ways iron is lost?

A

shedding of intestinal/skin cells
menstruation
abnormal bleeding
pregnancy

19
Q

What is the cause of megaloblastic anemai?

A

inability to synthesize adequate amounts of purines and thymidylate triphosphate for DNA synthase
folate def, vit B12 def, methionine synthase def

20
Q

What effect does methyltrexate have on purine synthesis?

A

inhibits dehydrofolate reductase, limiting puruine and thymidylate synthesis
causes drug induced megaloblastic anemia

21
Q

Sources of folate

A

veggie (esp dark green)
fruits, grains, nuts, beans, dairy, seafood, meat
cereal, rice

22
Q

sources of vitamin B12

A

meat, shellfish, milk, eggs

vegans must get supplement

23
Q

What role does saliva play in B12 uptake?

A

Salivary haptocorrin/R protein needed

24
Q

What cells secrete intrinsic factor?

A

parietal cells

25
Q

What is anemai caused by B12 deficiency formally called?

A

perniscious anemia

26
Q

What is anemia of chronic disease (inflammation)?

A

mild to moderate anemia associated with inflammatory disorders, infection, malignancy

27
Q

Common diseases associated with ACD?

A

chronic microbial infections
chronic immune disorders
Neoplasms

28
Q

ACD features?

A

reduced transport of iron to erythroid precursors, reduced or ineffective erythropoiesis, normal or increased iron stores

29
Q

Mechanism of ACD?

A

increased levels of IL-6 upregulares hepatic production of hepcidin, this leads to internalization nad lysosomal degradation of ferroportin and reduced release of iron into plasma

30
Q

Blood smear in ACD?

A

no noticeable polychromasia or increased anisocytosis

RBCs normochromic or nomocytic

31
Q

BM in ACD?

A

generally normocellular, may show diminished erythropoiesis

lack of sideroblasts

32
Q

What happens to ferritin levels during ACD? Transferrin?

A

ferritin often elevated

transferrin reduced

33
Q

Is total iron binding capacity elecated in ACD?

A

no