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Block 3 > W2 LECT 1: Iron and anaemia > Flashcards

W2 LECT 1: Iron and anaemia Flashcards

1
Q

where do we get iron from?
.

A

animal and plant products

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2
Q

outline features of iron obtained from animal products?

A
  • organic
  • more soluble
  • more absorbed
  • fe2+
  • 11 mg
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3
Q

outline features of iron obtained from plant products?

A
  • inorganic
  • less soluble
  • less absorbable
  • fe3+
    3 mg
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4
Q

how much iron do you need?

A

men: 14- 18 yrs 11mg/ day
19+ yrs 8 mg/ day
females: 14- 18 yrs 15 mg/ day
19-50 18mg/ day
preg. 27mg/ day
50+ yrs 8mg/day

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5
Q

what is the average intake of iron?

A

Average intake ~12mg
Only ~1-2mg absorbed (~6mg px)

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6
Q

what inhibits nonheme absorption?

A
  • phytate
    -oxalate
  • polyphenois
    -tannis
    -PPI
    -H pylori
  • inflammation
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7
Q

what induces nonheme absorption?

A
  • vit c
  • fe defiency
  • increased erythropoiesis
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8
Q

describe transportation of iron from stomach until hepcidin?

A
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9
Q

explain the transferrin cycle?

A
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10
Q

what is the iron stain found in tissues and bone marrow

A

hemosiderin

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11
Q

what increases ferritin levels?

A

-Increased iron status
- Inflammation
- Infection
- Liver disease
- Alcohol use disorder

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12
Q

what increases ferritin levels?

A

low iron status

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13
Q

how is the iron distributed in the body?

A
  • red cells 45%
  • liver 25%
  • macrophages 15%
    -muscle and erythropoiesis 7%
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14
Q

what:
1. FACILITATES IRON ABSORBTION
2. STORES IRON
3. BLOCKS IRON RELEASE
4. IRON EXPORTER
5. IRON TRANSPORTER

A

a. DMT-1
b. ferritin
c. Hepcidin
d. Ferriportin
d. Transferrrin

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15
Q

two types of iron overloads?

A

Primary = Hereditary haemochromatosis
* Mutations genes involved iron
regulation (HFE, C282Y, HJV, HAMP)
* low hepcidin iron loading tissue with
less in macrophages
* TSAT >45%, Ferritin >1000ug/L
* ? Fe deficiency possible

Secondary = Siderosis
* Blood transfusion, ineffective
erythropoiesis
* Iron accumulation in macrophages
* TSAT >45%, Ferritin >1000ug/L

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16
Q

what are the dignostic criteria for iron deficiency anaemia?

A
  • Hb: < 130 g/l males
    < 120 g/L females
    < 100g/L preg
    -ferritin : < 30 ug/l if no imflammtion
    < 100 ug/l if inflammation
  • transferrin, tot. iron binding capacity raised
  • iron is reduced
    mean corpuscular volume low
    transferrin saturations < 20%
17
Q

what are the differential diagnosis of iron def.?

A
  • Anaemia of chronic disease (ACD)
  • thalassaemia
  • sideroblastic anaemia
18
Q

what are the clinical manifestations of hereditary hemochromatosis?

A

liver: hepatomegaly, fibrosis, cirrhosis, HCC, elevTed liver enzymes
endocrine: diabetes, loss of libido, hypopituitarism, amenorrhea
skin: bronse skin
joints: arthritis, arthralgia, chondrocalcinosis
heart: heart failure, arrhythmias, cardiomyopathies

19
Q

what causes Fe anaemia?

A
  • caused by depletion of body iron stores.
  • most common: increased loss of iron
  • less common: inadequate iron intake, inadequate iron absorption, increased iron requirements e.g growth , preg.
20
Q

how do we diagnose iron deficiency?

A

anaemia= low ferritin

21
Q

what are the therapeutic princinples?

A
  • red cell transfusion
  • replenish iron stores: oral and IV iron
22
Q

what are the symptoms of iron def. and anemia?

A
  • anemia: fatigue, shortness of breath, headache, palpitations
    -iron def; restless legs. pica, hair loss, chipping of nails, sore tounge
23
Q

what are signs od anemia and iron def?

A
  • anemia: pallor, tachycardia
  • iron def: glossitis, chelittis, brittle nails, kolionychia
24
Q

what are the hematological findings following Fe deficiency?

A
  • microcytic hypochromic anemia
  • thrombocytotosis
  • lymphopenia
  • low reticulocyte count
  • cigar- shaped red cells on peripheral smear
25
Q

what are the iron indices?

A
  • low serum iron
  • high tibc- high soluble transferrin receptor
  • low ferrtin

Block 3 (51 decks)

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