5-3

Front 1

In what form is Iron absorbed by the small intestine?

Back 1

FE2+ form or part of a heme ring

Front 2

How are Iron levels adjusted physiologically?

Back 2

By changing the rate of absorption

Front 3

How do we lose iron?

Back 3

we lose about 1mg a day or 2 if your are a woman. Otherwise you need to bleed it out somehow

Front 4

Why is iron overload a bigger problem?

Back 4

We have no physiological method of getting rid of it

Front 5

Stores vs erythropoisis regulator?

Back 5

erythropoesis regulator is more potent and overrides the stors regulator

Front 6

Transferrin?

Back 6

carries 2 iron in ferrus form in the blood

Front 7

Describe how the transferrin receptor works?

Back 7

Transferrin with 2 iron binds and is pinocytosed. iron is realeased and the receptor is returned to the surface and transferrin is also released

Front 8

Ferritin? Is found where?

Back 8

storage molecule of iron. found in macrophages, hepatocytes and reticuloendothelial system

Front 9

Hemosiderin?

Back 9

another storage molecule for iron. thought to be partially degraded ferritin

Front 10

ferritin levels rise when?

Back 10

states of inflammation

Front 11

Hepsidin?

Back 11

regulatory molecule that works to decrease plasma iron.

Front 12

Max amount of iron that can be absorbed by the duodenum?

Back 12

4 mg a day

Front 13

conversion of ferric iron to ferrous iron requires?

Back 13

An acidic envirnment

Front 14

What is the channel that transpotts iron to the plasma?

Back 14

Ferroportin

Front 15

What form of iron binds transferrin?

Back 15

Ferric iron Fe3+

Front 16

2 things in the diet that increase iron absorption?

Back 16

Ascorbic acid and breast milk

Front 17

Why is cow's milk a bad idea for iron absorption?

Back 17

iron is hard to absorb and it can cause bleeding

Front 18

IRE and IRP?

Back 18

Iron regulatory protiens and Iron responsive elemets can alter gene transcription

Front 19

HAMP?

Back 19

Another name for Hepcidin. decreases plasma iron

Front 20

How does Hepcidin cause anemia?

Back 20

It blocks the transfer of iron to RBCs

Front 21

What 2 things stimulate HAMP transcription?

Back 21

Inflammatory cytokines and iron excess

Front 22

What happends to Serum iron, TIBC, Saturation % and ferritin during Iron deficency, inflammation and combined?

Back 22

Iron Deficency: Serum is low TIBC is high, Sat is very low and ferritin is low
Inflammation: Serum is low, TIBC is low, Sat is low and ferritin is high.
Combined: Serum is low, TIBC ?, Sat is low and Ferritin is ?

Front 23

some situations where there is increased plasma but hemoglobin is still normal?

Back 23

Pregancy, congestive heart failure and splenomegaly

Front 24

problems with the hemoglobin reference range?

Back 24

Reference rage is wide but the idividual's range is narrow

Front 25

symptoms of anemia?

Back 25

fatige
shortness of breath
paplitations
syncope

Front 26

factors that effect severity of symptoms?

Back 26

age, health, rate of onset

Front 27

PE signs of anemia?

Back 27

light Pallor, tachycardia, jaudise glossitis Angular cheilitis

Front 28

Hypoproliferative?

Back 28

Bone marrow is not stimulated. little cell turnover but they are normal

Front 29

Hyperproliferative?

Back 29

Bone marrow is making cells like crazy but the cells are getting destroyed

Front 30

Maturation Defect anemia?

Back 30

problem with production and are released early

Front 31

2 main causes of hypoproliferative anemias?

Back 31

1. decreased erythropoitin
2. decreased RBC precoursers in marrow

Front 32

3 main catagorie of maturation defect anemias and some examples?

Back 32

Cytoplasmic: iron deficiency, thalassemia
Nuclear: DNA synthesis defects and Vit B12 deficincy
combined:myelodyspasia

Front 33

2 types of hyperproliferative anemias?

Back 33

Hemorrahagic
Hemolytic

Front 34

Cause of a Microcytic MCV?

Back 34

defective cytoplasmic maturation

Front 35

Cause of Macrocytic MCV?

Back 35

reticulocytosis or defective nuclear maturation

Front 36

Hypochromia?

Back 36

widening of the normal central pallar

Front 37

sideroblastic anemia?

Back 37

disorder of porphyrin or heme synthesis

Front 38

Normocytic anemia with an appropriate marrow responce think?

Back 38

Hemhorrage and hylolysis

Front 39

Normocytic anemia with an inappropriate marrow responce think?

Back 39

marrow hypoplasia or infultration

Front 40

what can cause decreases erythropoitin? (5)

Back 40

Kidney disease, liver disease, endocrine disease, malnutrition, chronic inflammation

Front 41

Some types of macrocytic animias?

Back 41

Megaloblastic anemia, reticulocytosis, aplastic, myelodysplasia.

Front 42

Hypoproliferative?

Back 42

Bone marrow is not stimulated. little cell turnover but they are normal

Front 43

Hyperproliferative?

Back 43

Bone marrow is making cells like crazy but the cells are getting destroyed

Front 44

Maturation Defect anemia?

Back 44

problem with production and are released early

Front 45

2 main causes of hypoproliferative anemias?

Back 45

1. decreased erythropoitin
2. decreased RBC precoursers in marrow

Front 46

3 main catagorie of maturation defect anemias and some examples?

Back 46

Cytoplasmic: iron deficiency, thalassemia
Nuclear: DNA synthesis defects and Vit B12 deficincy
combined:myelodyspasia

Front 47

What would this suggest?

Back 47

Megaloblastic anemia due to folate dicicency or b12

Front 48

What is this?

Back 48

teardrop RBCs

Front 49

diagnosis?

Back 49

Sickle cell anemia

Front 50

Diagnosis?

Back 50

Sideroblastic anemia. iron has collected in the mitochondria around the cell. caused by defects in protopophorin synthesis

Front 51

Hepatoglobin?

Back 51

Bind to free hemoglobin in the plasma

Front 52

Decrease in hepatoglobin means?

Back 52

hemolysis because hepatoglobin is binging large amounts of free hemoglobin

Front 53

How does iron end up in urine?

Back 53

Intravascular hemolsis causes hemoglobin to be released into the plasma. it is filtered by the kidney and hemoglobin is released. iron is taken in and stored in the kidney cells untill they are sloughed off into the urine.

Front 54

Myelophthisis?

Back 54

means space occuping lesion in bone marrow

Front 55

Most common cause of iron deficiency?

Back 55

Blood loss specifically gastrointestinal bleeding

Front 56

Plummer-Vinson syndrome?

Back 56

combination of burning pain in the mouth due to glossitis and dysphagia due to esophageal webs seen often in iron deficincy

Front 57

3 mechanisms of anemia caused by inflammation?

Back 57

1. cytokines decrease erythropoitin and it effect on bone marrow
2. cytokines increas hepsidin levels
3. activation of macrophages increases hemolysis