Anemia and Hematopoietic GF

Question 1

the mcc of anemia is what?

Answer 1

insufficient supply of iron, vit b12 or folic acid - all 3 are necessary for production of RBC

Question 2

what is the mc type of anemia?

Answer 2

microcytic hypochromic anemia caused by iron deficiency

Question 3

what is the most common type of vitamin b12 anemia? what is the cause?

Answer 3

pernicious anemia; defect in synthesis of intrinsic factor - protein required for absorption of b12

Question 4

what are the transport and storage proteins of iron respectively?

Answer 4

transferrin and ferritin

Question 5

true or false: there is no mechanism for efficient excretion of iron, regulation of body iron.

Answer 5

true - this is why regulation of body iron occurs through modulation of intestinal absorption

Question 6

remember, iron is taken up into the intestines as ferrous iron. what then happens to intestinal iron?

Answer 6

intestinal cell iron is either stored as ferritin or the ferrous iron is transported across the basolateral membrane by ferroportin and oxided to ferric iron by ferroxidase

Question 7

true or false: minimal amounts of iron are lost from the body with sweat and saliva.

Answer 7

true

Question 8

what is the only clinical administration for iron?

Answer 8

prevention or tx of iron deficiency anemia

Question 9

what is the dietary supplement given to iron deficiency pts?

Answer 9

ferrous sulfate, ferrous gluconate or ferrous fumarate

Question 10

what is special about iron dextran, sodium ferric gluconate complex and iron sucrose? (in terms of their preparation)

Answer 10

they are parenteral iron preparations

Question 11

should you give iron in hemolytic anemia?

Answer 11

NEVER - b/c iron stores are ELEVATED and not depressed in this type of anemia

Question 12

acute iron intoxication is most common in which demographic?

Answer 12

children; typically they ingest iron supplementation tablets by accident

Question 13

what are some of the signs and sx of iron toxicity?

Answer 13

depending on the dose it can range from narcotizing gastroenteritis, shock, metabolic ACIDOSIS, coma and even death.

Question 14

chronic iron overload is known as what?

Answer 14

hemochromatosis - remember that this state damages the organs that store excess iron (heart, liver and pancreas)

Question 15

what are the two ways you can get hemochromatosis?

Answer 15

either via inherited abnormality of iron absorption or from frequent transfusions

Question 16

what is the DOC that chelates iron that is used in treatment of acute iron intoxication?

Answer 16

deferoxamine

Question 17

what is the treatment option for genetic form of hemochromatosis?

Answer 17

phlebotomy

Question 18

what is the treatment for chronic iron toxicity that is NOT genetic?

Answer 18

deferoxamine OR the newer deferasirox which does the name thing.

Question 19

true or false: impairment of synthesis of DNA is felt more with RBCs b/c they must be produced continuously?

Answer 19

TrUE - remember that vit b12 and folic acid are necessary in the transfer of 1-carbon units which is a necessary step in DNA synthesis

Question 20

how is vit b12 produced?

Answer 20

by bacteria and CANNOT be synthesized by multicellular organisms; remember it is absorbed in the GI tract in the presence of intrinsic factor

Question 21

true or false: vit b12 is stored in the liver in large amounts

Answer 21

true - two forms: cyanocobalamin and hydroxycobalamin (this last one has a longer half life)

Question 22

vitamin b12 is essential in what two reactions?

Answer 22

conversion of methylmalonylcoenzyme A (CoA) to succinyl-CoA and also the conversion of homocysteine to methionine. the second reaction is linked to folic acid metabolism and synthesis of deoxythmidylate (dTMP).