5.3.1

Question 1

What are the three important pathways of iron once it is utilise by the mithochondria?

Answer 1

-Heme Synthesis
-Fe-S clusters Biogenesis
-Mithochondrial Iron Storage (ferritin)

Question 2

What is the tetramer of four globin chains with heme attach to each globin chain?

Answer 2

-Hemoglobin

Question 3

These are bonds that are located between the diamers.

Answer 3

-a1B2 and a2B1 bonds

Question 4

What is the hormone secreted by the Hepatocytes?

Answer 4

-Hepcidin

Question 5

What will happen if the Fe level is low?

Answer 5

-hepcidin will increase, recycling and absorption will also be activated. (if increase then the hepcidin will increase also but will inactivate the absorption of erythrocytes and the recycling of the macrophages and hepatocytes)

Question 6

What is the most common form of anemia?

Answer 6

-IDA (iron dificiency anemia)

Question 7

What is the good indicator of iron storage status and the first laboratory test that will result in abnormal IDA?

Answer 7

-Serum Ferritin

Question 8

The sample of this test must be drawn early in the morning and required 12 hour fasting?

Answer 8

-Serum Iron

Question 9

This can be measured by a hematoflourometer or by an extraction of flourescence method?

Answer 9

-FEP (free erythrocyte porphyrin)

Question 10

Measures the maximum amount of iron that can bind to serum transferrin and an indirect measure of the protein transferrin?

Answer 10

-TIBC (total iron binding capacity)

Question 11

How many grams of iron that the human body contain?

Answer 11

-4g

Question 12

If the 60% of the iron stored in blood, then where’s the remaining of it stored?

Answer 12

-ferritin or hemosiderin

Question 13

Disease that occurs when the iron stores in the body have been depleted?

Answer 13

-IDA

Question 14

What stage of IDA that the functional iron depletes and the blood becomes microcytic and hypochromic?

Answer 14

-Stage 3 (Stage 1 - storage iron & Stage 2 - transport iron)

Question 15

What are the clinical symptoms of IDA?

Answer 15

-fatigue, weakness, diziness, pica, stomatitis, glossitis, koilonychia

Question 16

Clinical symptoms of IDA that is when a person is craving or eating unusual food such as starch?

Answer 16

-Pica

Question 17

Sore tongue?

Answer 17

-Glossitis

Question 18

Spooning of the nails?

Answer 18

-Koilonychia

Question 19

What will show under the microscope if the blood smear we used is from a patient that has IDA?

Answer 19

-Ovalocytes or pencil forms of cells

Question 20

This is the 2nd most common form of anemia and most common in hospitalized patients?

Answer 20

-ACD (Anemia of Chronic Disease)

Question 21

Erythocytes during ACD cannot aquire iron salvage due to the lack of lactoferritin receptors. What is this substance?

Answer 21

-Lactoferritin

Question 22

What influences the intestinal iron absorption and the release of iron in the macrophages?

Answer 22

-Hepcidin

Question 23

Substance secreted bby macrophages that inhibits erythropoiesis and stimulates neutrophils to lactoferrin?

Answer 23

• IL 1

Question 24

What substance that increases when iron storage in the body becomes low and decreases when the storage becomes high?

Answer 24

-Transferrin

Question 25

Hepatocyte production of transferrin is regulated by?

Answer 25

-intracellular iron levels

Question 26

What is the hallmark of sideroblasmic anemia?

Answer 26

-Ringed sideroblast

Question 27

It is characterized by iron loading and the accumulation of ferric iron in the mithochondria due to a defect in the heme synthesis?

Answer 27

-Sideroblastic anemia

Question 28

Cells that are iron-containing normoblast in the Bone marrow.

Answer 28

-sideroblast

Question 29

Iron deposits in the sideroblast can be identified using what kind of stain?

Answer 29

-prussian blue stain

Question 30

What type of sideroblast where ringed sideroblast are visible?

Answer 30

-Type 3

Question 31

What are the cause of aquired secondary sideroblastic anemia?

Answer 31

-drugs and bone marrow toxins

Question 32

Most common cause of sideroblastic anemia.

Answer 32

-alcoholism

Question 33

Type of sideroblastic anemia that is associated with decrease ALA-synthase and BM erythroid hyperplasia?

Answer 33

-Idiopathic sideroblastic anemia

Question 34

Type of sideroblastic anemia that follows afterr exposure to certain drugs and toxins?

Answer 34

-Secondary sideroblasstic anemia

Question 35

Certain drugs that trigger secondary sideroblastic anemia.

Answer 35

-isoniazid -cycloserine -pyranizamide

Question 36

What is the coenzyme that inhibits the reactions of the drugs?

Answer 36

-pyridoxal-5'-phosphate

Question 37

What is the other name for Lead poisoning?

Answer 37

-Plumbism

Question 38

This disease seen mostly to children due to lead-based paint?

Answer 38

-Lead poisoning

Question 39

What is the acceptable levels of lead in children?

Answer 39

-15-40 ug/dl of WB

Question 40

Lead Inhibits:

Answer 40

-Ala dehydratase or PBG synthase (most sensitive) -Heme synthesis -Coproporphyrinogen oxide

Question 41

What is an enzyme that involves in the breakdown of RNA in reticulocytes that causes ribosomes to aggregates?

Answer 41

-Pyrimidine 56-nucleotidase

Question 42

It is the formation of blue or black deposits of lead sulphate near the teeth.

Answer 42

-gum lead line

Question 43

This is a inherited disorder cause by specific enzye defects necessary for the synthesis or protoporphyin resulting to decreased hemoglobin.

Answer 43

-Prophyrias

Question 44

What is the precursor of abnormal protoporphyin?

Answer 44

-Prophyrins

Question 45

Clinical Features of Major Porphyrias

Answer 45

-AIP -CEP -HCP -VP -PCT

Question 46

What is the screening test of urine, red blood cells and feces for porphyrins?

Answer 46

-Watson-schwartz test

Question 47

This is called to patient's have bronze colored skin tht later develop to type 1 DM?

Answer 47

-Bronze diabetes

Question 48

This result from mutations that impair the Hepcidin-ferroportin iron regulatorry system.

Answer 48

-Heriditary hemochromatosis

Question 49

This also results from iron accumulation that causes little injury.

Answer 49

-Hemosiderosis

Question 50

These two forms during the body first reaction to store excess iron resulting tissue damage.

Answer 50

-ferritin and hemosiderin

Question 51

It is the iron aquisitions that exceeds the rate of loss.

Answer 51

-Iron Overload

Question 52

What are called the cracks in the corner of the mouth?

Answer 52

Stomatitis