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CC2 LECTURE > TRACE METALS > Flashcards

TRACE METALS Flashcards

1
Q

TRACE ELEMENTS

Associated with

A

enzymes or proteins

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2
Q

Essential: deficiency impairs a biochemical or functional process

A

TRACE ELEMENTS

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3
Q

The essential trace elements are usually associated with enzymes and serves as (?) in enzymatic reactions.

A

cofactor

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4
Q

An element is to be considered (?) if the deficiency impairs a biochemical or functional process and replacement of the impairment corrects this impairment.

A

essential

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5
Q

Laboratory determination

A

Anti-coagulated blood

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6
Q

Ideal:

A

anticoagulated blood samples

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7
Q

Low concentration in the plasma and ubiquitous nature

A

TRACE ELEMENTS

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8
Q

Prevent contamination

A

TRACE ELEMENTS

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9
Q

Method of choice:

A

Atomic absorption spectrophotometry

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10
Q

Most abundant trace element in the body wherein about 40 to 50 mg of iron is present per kilogram body weight

A

Iron

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11
Q

Iron containing proteins are important in the metabolism such as

A

collagen, tyrosine and catecholamines

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12
Q

of iron is imp for Hb synthesis

Anemia

A

30%

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13
Q

is the second most abundant trace metal in the body and is known to be a cofactor for almost 300 enzymes

A

Zinc

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14
Q

Zinc Essential in the:

A
  1. Structure
  2. Regulation
  3. Catalytic activity of 300 enzymes
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15
Q

important in the synthesis and metabolism of RNA and DNA

A

Zinc

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16
Q

Zn plays a role in the synthesis, (?) as well as in (?), the decrease in Zn will affect the ability of the islet cell to produce and secrete insulin, that may contribute to the development of Type 2 diabetes

A

storage and secretion of insulin

conformational integrity of insulin

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17
Q

• Hormone produced by the pancreas to regulate blood sugar

A

INSULIN

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18
Q

• Associated with Type 2 diabetes

A

INSULIN

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19
Q

is the third most abundant trace metal in the body

A

Copper

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20
Q

Cu Sources :

A

shellfish, liver, nuts and legumes

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21
Q

Cu Dietary requirement:

A

1.5-3.0 mg/day

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22
Q

Participates in:

A
  1. Cellular respiration
  2. DNA & RNA reproduction
  3. Maintains cell membrane integrity
  4. Sequestration of free radicals
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23
Q

: unstable atoms that can damage cell causing cell to age

A

free radicals

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24
Q

Iron majorly found in the following:

A

Hemoglobin synthesis in RBC

Ferritin and hemosiderin

myoglobin and non heme enzymes

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25
Q

– most imp use of iron in the body

A

Hemoglobin synthesis in RBC

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26
Q

as iron stores

A

Ferritin and hemosiderin

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27
Q

Moderate amount is found in body tissue such as

A

myoglobin and non heme enzymes

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28
Q

Iron bound to (?) which is the first to become diminished in iron deficiency conditions

A

transferrin

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29
Q

blood plasma glycoprotein playing a central role iron metabolism; delivers/transfers iron

A

transferrin

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30
Q

Iron Dietary iron:

A

ferrous form (Fe2+) for absorption

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31
Q

Primary regulation:

A

absorption thru the intestines

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32
Q

present in the food

A

Ferric form (Fe3)

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33
Q

Cannot be absorbed in the intestines

A

Ferric form (Fe3)

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34
Q

Iron absorption facilitated by

A

Ascorbic acid & other reducing agents
acid pH in the stomach

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35
Q
  • glycoprotein that transports Iron
A

Transferrin

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36
Q

measure of plasma transferrin level (NV: 56 mol/L)

A

Total Iron Binding Capacity

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37
Q

best to measure blood’s ability to attach itself to iron and transport iron around the body

Low iron level = anemia

A

Total Iron Binding Capacity

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38
Q
  • found virtually in all cells
A

Ferritin

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39
Q

Iron store: synthesis of iron-containing compounds

Increased serum ferritin:

A

Fever
Acute infections
Rheumatoid arthritis
Viral hepatitis

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40
Q

is mainly absorbed from the duodenum.

A

Zinc

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41
Q

Zinc is mainly absorbed from the.

A

duodenum

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42
Q

In blood, bound to (?)

A

albumin and α-2 macroglobulin

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43
Q

(?) contain most of the body’s Zn stores.

A

bones and the muscle

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44
Q

slow turnover (half-life of ?)

A

300 days

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45
Q

In the liver, zinc is bound to (?).

A

metallothionein

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46
Q

: zinc transporter protein

A

METALLOTHIONEIN

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47
Q

METALLOTHIONEIN half-life is

A

~2 weeks

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48
Q

Zn Dietary Sources:

A

o Oyster
o Lamb meat
o Beef
o Seafoods (crab, lobsters)
o Cashew
o Cheese and dairy products
o Beans and legumes

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49
Q
  • highest copper concentration
A

Liver

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50
Q

-containing proteins

A

Copper

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51
Q
  • synthesized in the liver Cu
A

Ceruloplasmin

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52
Q

-bound Cu

A

Albumin

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53
Q
  • transporter protein Cu
A

Transcuperin

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54
Q
  • sequesters and stores copper Cu
A

Metallothionein

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55
Q
  1. Iron depletion
A

Iron Deficiency

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56
Q
  1. Iron Deficiency Anemia
A

Iron Deficiency

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57
Q

Blood loss due to GI bleeding

A

Iron Deficiency

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58
Q

Chronic drug ingestion

A

Iron Deficiency

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59
Q

Parasitic infection

A

Iron Deficiency

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60
Q

Impaired absorption of iron

A

Iron Deficiency

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61
Q

Renal failure

A

Iron Deficiency

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62
Q

Iron Overload Common causes:

A

Hereditary hemochromatosis

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63
Q

Hereditary hemochromatosis

A

Iron Overload

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64
Q

Sideroblastic anemia

A

Iron Overload

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65
Q

Chronic ingestion of medicinal iron

A

Iron Overload

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66
Q

Chronic hepatitis

A

Iron Overload

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67
Q

Diabetes mellitus

A

Zinc deficiency

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68
Q

Alcohol abuse

A

Zinc deficiency

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69
Q

Malabsorption syndrome

A

Zinc deficiency

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70
Q

Liver and kidney disease

A

Zinc deficiency

71
Q

Acrodermatitis enteropathica

A

Zinc deficiency

72
Q

Common among premature infants and undernourished children

A

Copper deficiency

73
Q

related to malnutrition, malabsorption, and chronic diarrhea and prolonged feeding with low-copper, total-milk diets

A

Copper deficiency

74
Q

Cu main cause:

A

low-copper diet (milk)

75
Q

Cu Contributing factor in adults:

A
  1. osteoporosis/ bone&joint abnormality
  2. Cardiovascular disease /Coronary Heart Disorders(CVD)
76
Q

Menke’s disease or “kinky hair syndrome

A

Copper deficiency

77
Q

Menke’s disease or “kinky hair syndrome Clinical features:

A

• Diminished copper conc. in hair
• Decrease in ceruloplasmin
• peculiar hair/stilly hair

78
Q

Increased tissue and serum levels

A

Copper toxicity

79
Q

Mostly caused by Acute copper poisoning coming from fungicides

A

Copper toxicity

80
Q

WILSON’S DISEASE

A

Copper toxicity

81
Q

WILSON’S DISEASE Triad of Manifestations:

A

Neurologic disorders

Liver dysfunction

Kayser-Fleischer rings

82
Q

composed of diff mental signs and symptoms; caused by accumulation of cu+ in the brain (symptoms: Alzheimer’s, dementia, hallucination, schizophrenia)

A

Neurologic disorders

83
Q

: sequestration of drugs For bilirubin metabolism and sequestration of drugs

A

Liver dysfunction

84
Q

Liver

A

Liver dysfunction

85
Q

green-brown discoloration in the cornea

A

Kayser-Fleischer rings

86
Q

Decreased release of ferritin

A

Iron Deficiency

87
Q

Most serious cause of GI bleeding:

A

Hookworm anemia

88
Q

Hookworm:
Bites in the walls of SI

A

Necator americanus

89
Q

Kidney disease

EPO - synthesized in the kidney; imp for rbc devt

A

Iron Deficiency

90
Q

The following shows symptoms of hemochromatosis

A
  1. Hereditary hemochromatosis
91
Q

is a disorder that causes the body to absorb too much iron from the diet. Sideroblastic anemia, Chronic ingestion of medicinal iron, Chronic hepatitis

A

Hereditary hemochromatosis
Sideroblastic anemia
Chronic ingestion of medicinal iron
Chronic hepatitis

92
Q

most common cause of iron overload

A
  1. Hereditary hemochromatosis
93
Q
  1. Hereditary hemochromatosis

caused by accumulation of iron in the

A

liver and skin

94
Q

causes hyperpigmentation of the skin

A
  1. Hereditary hemochromatosis
95
Q

BM produces ringed sideroblasts

A

Sideroblastic anemia

96
Q

Hepa C infection

A

Chronic hepatitis

97
Q

causes reduction in the effects of antiretroviral drugs

A

Chronic hepatitis

98
Q

– low zinc and insulin levels

A

Diabetes mellitus

99
Q

– Cofactor of Alcohol Dehydrogenase (function by the liver)

A

Alcohol abuse

100
Q

develops among infants; facial rash with diaper rash

A

Acrodermatitis enteropathica

101
Q

prominent observable feature

A

Menke’s disease or “kinky hair syndrome

102
Q

form of extreme def in cu+ observed among newborns and babies

A

Menke’s disease or “kinky hair syndrome

103
Q

problem in the absorption of cu

A

Menke’s disease or “kinky hair syndrome

104
Q

affects both mental and physical retardation

A

Menke’s disease or “kinky hair syndrome

105
Q

severe cases: weak muscle tone (hypotonia); sagging features

A

Menke’s disease or “kinky hair syndrome

106
Q
  • agricultural workers/infestations control; inhalation of mist containing cu+ sulfate
A

fungicides

107
Q

– most important genetically determined copper accumulation disease

A

WILSON’S DISEASE

108
Q

Copper deposits in tissues liver, brain & corned)

A

WILSON’S DISEASE

109
Q

quantitative, specific, & sensitive

A

Direct measurements

110
Q

involve invasive procedures

A
111
Q

is digested and analyzed for iron

A

Liver biopsy

112
Q

is used as a substitute for biopsy in monitoring iron overload

A

quantitative phlebotomy

113
Q

Examples of Fe Direct measurements

A
  1. Quantitative phlebotomy
  2. Bone marrow biopsy
  3. Liver biopsy
114
Q
  •  performed if liver biopsy is not available; to document iron overload
A
  1. Quantitative phlebotomy
115
Q
  1. Fe Quantitative phlebotomy

(?) phlebotomies

(?) mL (1 blood bag)

A

16 to 20

450

116
Q

digested and analyzed for iron; first option

A

Liver biopsy

117
Q

Fe Indirect methods Serum iron is measure by:

A
  1. Colorimetric method
  2. AAS
118
Q
  • Zinc is highest in the morning.
A

Diurnal variation

119
Q
  • Zinc is highest when fasting;
A

Postprandial variation

120
Q

Serum values 10% greater than plasma values

A

Postprandial variation

121
Q

The RBC has (?) more zinc than the plasma hence hemolysis should be avoided.

A

10x

122
Q

The reference method for zinc measurement is.

A

AAS

123
Q

Other methods (Not usually used for medical purposes; tedious):

A
  1. Flame Atomic Absorption Spectrometry (FAAS)
  2. Inductively coupled plasma - mass spectrometry (ICP-MS)
124
Q
  • method of choice for Zn in body fluids
A
  1. Flame Atomic Absorption Spectrometry (FAAS)
125
Q
  • reference Testing method in serum or plasma
A
  1. Inductively coupled plasma - mass spectrometry (ICP-MS)
126
Q

Serum or urine copper can measure using (?) which is the method of choice or

A

AAS

colorimetric method.

127
Q

Ceruloplasmin is measured by

A

photometric method and immunochemical methods.

128
Q

Total Fe++:

A

60 – 150 µg/dL

129
Q

TIBC:

A

250 – 400 µg/dL

130
Q

Iron Sat’n:

A

20 – 55%

131
Q

Ferritin:

A

Male: 15 – 200 µg/L
Female: 12 – 200 µg/L

132
Q

Zn PLASMA REFERENCE VALUE:

A

70 - 120 g/dL (10.7 - 18.4 pmol/L)

133
Q

Serum Copper

A

Male: 70 – 140 µg/dL (11 – 22µmol/L)
Female: 80 – 155 µg/dL (13 – 24µmol/L)

134
Q

Ceruloplasmin:

A

23 – 50 mg/dL

135
Q

Constituent of vitamin B12

A

Cobalt

136
Q

Folate metabolism

A

Cobalt

137
Q

Erythropoiesis

A

Cobalt

138
Q

Toxic at high doses

A

Cobalt

139
Q

Cobalt Laboratory determination :

A

AA’S

140
Q

Naturally occurring; industrial waste

A

Chromium

141
Q

Chromium: rich sources

A

Meat and grains

142
Q

Chromium

Once absorbed, transported to the tissue by

A

transferrin

143
Q

Chromium In glucose metabolism:

A

Insulin cofactor

144
Q

Chromium Deficiency :

A

insulin resistance

145
Q

Chromium supplementation:

A

improved glucose tolerance, reduced insulin concentrations, decreased total cholesterol

146
Q

Prevention of dental caries

A

Fluoride

147
Q

Fluoride Excess:

A

mottling of teeth and calcification in soft tissues

148
Q

Minimize bone loss or stimulate bone formation

A

Fluoride

149
Q

Readily absorbed by the gut and distributed almost totally to the bone and teeth

A

Fluoride

150
Q

Fluoride Laboratory determination:

A

ISE

151
Q

Manganese

Activator of several enzyme systems Ex:

A

Arginase, pyruvate carboxylase, superoxide dismutase

152
Q

Manganese

Transported in plasma by

A

albumin, a2-macroglobulin and transferrin

153
Q

Manganese Deficiency :

A

seizures and epilepsy (rare)

154
Q

Manganese Excess:

A

Locura manganica

155
Q

Manganese madness

A

Locura manganica

156
Q

First discovered among children in some parts of south America

A

Locura manganica

157
Q

Inhalation of Mg from aerosol gases in mines

A

Locura manganica

158
Q

Molybdenum

Essential cofactor for several

A

oxidase enzymes

159
Q

: Converts hypoxanthine to uric acid

A

Xanthine DH/xanthine oxidase

160
Q

: Catalyzes conversion of acetyl-CoA to acetate

A

Aldehyde oxidase

161
Q

: Converts sulfite to sulfate

A

Sulfite oxidase

162
Q

Molybdenum is mostly absorbed in

A

stomach and small intestines

163
Q

inhibit Molybdenum absorption

A

Copper and iron

164
Q

Molybdenum Excess :

A

inhibition of copper dependent enzymes (ceruloplasmin-or cytochrome oxidase)

165
Q

Molybdenum Excess:(Facilitates conversion of hypoxanthine to uric acid)

A

hyperuricemia and gout

166
Q

Selenium

Cofactor in

A

glutathione peroxidase and iodothyronine deiodinase

167
Q

: essential amino acid coded by DNA (Maintains metabolic rate of selenium)

A

Selenocysteine

168
Q

: can substitute for methionine as essential amino acid

A

Selenomethionine

169
Q

Antioxidant properties

A

Selenium

170
Q

Involved in metabolism of thyroid hormone

A

Selenium

171
Q

Selenium Deficiency

A

Cardiomyopathy and skeletal muscle weakness

Osteoarthritis and increased incidence of cancer

172
Q

Selenium Supplementation

A

Decreased risk of cancer (stomach, lung and prostate)

173
Q

Selenium Laboratory determination :

A

AAS

CC2 LECTURE (33 decks)

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