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59 Cards in this Set
- Front
- Back
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what type of iron is not affected in iron deficiency? |
functional iron |
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populations typically affected by iron deficiency |
children women elderly |
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causes of IDA |
pregnancy menstruation GI bleed malabsorption crohn's or celiac parasite |
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stage 1 of IDA |
iron depletion decrease in ferritin no symptoms |
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stage 2 of IDA |
iron deficient erythropoiesis decrease in ferritin and serum iron increased TIBC |
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what does the RBC look like in stage 2 IDA? |
slightly microcytic no hypochromia no anemia |
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stage 3 of IDA |
iron deficiency decrease in hgb, ferritin, serum iron decrease in peripheral tissue oxygen delivery increased TIBC |
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how do the RBCs look at stage 3 IDA? |
microcyte, hypochromic anemia pt has symptoms of decreased tissue oxygen delivery all lab test abnormal |
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lab features of IDA |
microcytic hypo chromic anisocytosis poikilocytosis total iron and ferritin decreased TIBC increased |
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anemia of chronic inflammation |
decreased hemoglobin production due to decreased amount of free iron |
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lab feature of anemia of chronic disease |
iron, TIBC decreased (transferrin is a negative acute phase reactant) ferritin increased (ferritin is a positive acute phase reactant) |
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mechanism of anemia of chronic disease |
increase in interleukin 6 from macrophages increase in hepcidin from liver hepcidin blocks ferroportin in the gastrointestinal tract and macrophages |
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positive acute phase proteins in anemia of chronic disease |
hepcidin ferritin |
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hemochromatosis |
-primary/hereditary iron accumulation hemosiderin deposited within cells and interstitial fluid -irreversible |
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what organs are effected in hemochromatosis? |
liver, heart, endocrine glands |
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hemosiderosis |
secondary/ascquired iron accumulation hemosiderin stored in cells only -reversible |
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what patients are at risk for hemosiderosis? |
Patients with transfusion dependent disorders |
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lab ID of hemochromatosis |
total iron increased percent saturation increased (dx value is 60%) TIBC decreased |
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why do patients with hemoglobinopathes have increased ferritin? |
accelerated erythropoiesis hyper cellular bone marrow and ineffective erythropoiesis triggers storage of iron |
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clinical symptoms of porphyrias |
port wine urine cutaneous photosensitivity itchy skin hyper pigmentation inflammatory rxn to UV light |
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cutaneous porphyria have accumulation in what precursors? |
late precursors URO, COPRO, PROTO |
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sample requirements for iron studies |
heparin anticoagulant no hemolysis early morning sample preferred |
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iron panel |
-total serum iron (bound to transferrin) -TIBC (serum iron and the UIBC) -percent iron saturation: ratio of serum iron to TIBC |
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most sensitive indicator for iron depletion |
ferritin (stage 1) |
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what is useful to diagnose hypo chromic anemia? |
transferrin |
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indirect measure of iron levels |
TIBC |
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how to express percent saturation? |
% Fe saturation=(total iron/TIBC)*100 |
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Fe reference ranges |
men: 65-175 micrograms/dL women: 50-170 micrograms/dL |
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causes of increased iron |
increased absorption lead poisoning pernicious anemia megaloblastic anemia hepatitis |
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ferritin reference ranges |
male: 20-250 ng/mL female: 10-120 ng/mL |
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% saturation reference range |
15-50% (60% and greater dx for iron overload) |
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enrich watson test |
test that differentiates between urobilinogen and pophobilinogen used to dx porphyrias |
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specimen requirements for lead analysis |
whole blood (circulating Pb found in the RBC) royal blue top with EDTA lead free containers urine |
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what types of hormones produce short term effects? |
proteins/peptides |
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what type of hormones produce short and long term effects? |
Amines |
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what type of hormones produce long lasting effects? |
steroids |
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how do steroidal hormones cause effects? |
transversing through the cell membrane and binding inside the cell |
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what is a tropic hormone? |
originates from anterior pituitary gland specific for another endocrine gland |
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what is a non tropic / direct effector hormone? |
secreted from non-pituitary gland act directly on peripheral tissue exert a feedback effect on the hypothalamus or anterior pituitary gland |
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how is production of hormones regulated? |
By controlling rate of synthesis |
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what is the primary type of feedback control? |
negative feedback |
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hormones secreted by the anterior pituitary |
lactotrophs somatotrophs thyrotrophs corticotrophins gonadotrophs |
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hormones secreted by posterior pituitary |
oxytocin AVP |
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LH |
promote ovulation formation of corpus lute secretes androgens |
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FSH |
stimulates growth of follicles secretion of estrogens and ovulation stimulates development of seminiferous tubules spermatogenesis |
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ACTH action |
promotes growth of adrenal cortical tissue stimulates production of adrenal steroids |
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ACTH target cell |
adrenal cortex |
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when are ACTH hormones highest? |
6-8 am |
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what kind of hormone is GH/somatotropin? |
direct effector |
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how is GH secreted? |
in pulse: every 2-3 hrs |
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when does GH peak? |
onset of sleep |
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what inhibits GH? |
somatostatin |
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what stimulates GH? |
GHRH |
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what characteristic is unique to GH? |
amphibolic: influences both anabolic and catabolic processes |
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what hormone does GH directly antagonize? |
insulin |
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effects of GH |
hepatic gluconeogenesis lipolysis protein synthesis in skeletal muscle |
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what type of hormone is prolactin? |
direct effector |
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what stimulates prolactin? |
thyrotropin releasing hormone (TRH) |
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what inhibits prolactin? |
dopamine |
