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PMCOL 344 > Hematopoietic System-Iron > Flashcards

Hematopoietic System-Iron Flashcards

1
Q

what is Hematopoiesis

A

formation of blood cells from stem cell precursors

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2
Q

what composes the hematopoietic system

A

bone marrow, blood, thymus, lymph nodes, kidney spleen liver

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3
Q

what is the role of the kidney in the hematopoietic system

A

produces erythyopoietin

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4
Q

what is the role of the spleen in the hematopoietic system

A

breakdown of RBC, recycle hemoglobin, iron

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5
Q

what is the role of the liver in the hematopoietic system

A

stores iron

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6
Q

what are the 2 main pathways that stem cells can form (like blood cells)

A

myeloid and lymphoid

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7
Q

what is anemia

A

insufficient RBC mass to adequately deliver oxygen to peripheral tissues due to decrease in RBC number or concentration of hemoglobin

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8
Q

what are anemia symptoms

A

fatigue, weakness, lightheadedness, dyspnea, decreased exercise tolerance

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9
Q

what are 2 main types of anemia

A

chronic and acute

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10
Q

what is acute anemia

A

severe blood loss

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11
Q

what kind of anemia is acute anemia and why

A

normocytic because there is normal volume of the RBC

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12
Q

what are 3 main types of chronic anemia

A

microcytic and macrocytic and renal failure anemia

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13
Q

what is anemia of chronic renal failure

A

problem with kidneys, kidneys cant make EPO

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14
Q

what are 5 causes of chronic anemia

A
  • dietary deficiency
  • chronic minor blood loss
  • disorder of organ responsible for manufacture/uptake of factors essential for RBC production
  • depression of bone marrow
  • haemolytic anemias
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15
Q

what causes microcytic anemias

A

not enough iron

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16
Q

what causes macrocytic anemias

A

not enough folate or B12

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17
Q

what are 3 things that cause depression of bone marrow

A

drug toxicity, radiation/radiotherapy, diseases of bone marrow

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18
Q

what are 2 haemolytic anemias

A

sickle cell, thalassemia

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19
Q

what are 4 examples of hematinic agents

A

iron compounds
vit B12 compounds
folates
haematopoietic growth factors - EPO

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20
Q

when do you use iron compounds

A

for iron deficiency anemia

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21
Q

what are the RBC like structually in iron deficiency anemia and why

A

they are smaller due to lower Hb content-microcytic

also hypochromatic

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22
Q

what % of body iron circulates as Hb in RBCs

A

65%

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23
Q

what % of body iron is stored as ferritin in tissues

A

25%

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24
Q

what % of body iron is myoglobin as transferrin

A

10%

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25
Q

what is ferritin

A

protein that binds to iron in tissue

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26
Q

what is transferrin

A

peptide that binds to iron

27
Q

where is myoglobin

A

in skeletal muscle

28
Q

where does iron absorption occur

A

in duodenum

29
Q

how much iron gets absorbed daily

A

1mg

30
Q

what is the storage form of iron

A

ferritin

31
Q

how can iron enter the duodenum

A

either absorbed as heme-iron (HCP1) or taken up via DMT1 with H+

32
Q

how does heme iron enter duodenal cell

A

HCP1

33
Q

how does non heme iron enter duodenal cell

A

DMT1 with H+ co transport

34
Q

how does Fe3+ become Fe2+

A

via DCYTB

35
Q

which form of iron is better absorbed (charge)

A

Fe2+

36
Q

what happens to heme iron once its inside the cell

A

heme oxidase releases Fe++ from it

37
Q

what are 2 main things that can happen with free iron in the cell

A

ferroportin gets it out of the cell into blood or it makes ferritin inside the cell

38
Q

what happens once Fe++ leaves the duodenal cell

A

hephaestin turns it into Fe+++

39
Q

what does Fe+++ do (after it left the cell)

A

joins plasma apotransferrin to become transferrin

40
Q

what does heme oxidase do

A

releases Fe2+ from heme iron

41
Q

what happens when transferrin enters a new cell (4)

A
  • joins a lysosome
  • breaks into apotransferrin (which leaves the cell) and Fe+++
  • reductase turns Fe+++ to Fe++
  • Fe++ leaves lysosome and is used to make Hb
42
Q

what is it called when transferrin fuses with lysosome

A

endosome

43
Q

what are 3 main causes of iron deficiency anemia

A

inadequate dietary intake, inadequate absorption, chronic blood loss

44
Q

what 2 things can cause inadequate absorption

A

gastrectomy, diseases of GI tract

45
Q

what are some things that cause chronic blood loss

A

GI bleeding things (ulcers, cancer), menorrhagia, hookworm

46
Q

what are 3 types of oral iron therapy

A

ferrous sulphate, ferrous fumarate, ferrous gluconate

47
Q

what is the most common iron supplement

A

ferrous sulphate

48
Q

what are some things that decrease iron absorption and why

A

things that chelate iron, antacids and PPIs

49
Q

what is a thing that increase iron absorption

A

vitamin C

50
Q

what are 3 types of natural things that affect iron absorption + how

A

phytates (nuts, seeds, grains - inhibit iron)
polyphenols (beans, tea, coffee - interfere)
Ca++ Zn++ Mg++ compete for upate

51
Q

what are some adverse effects of iron oral therapy

A

cramps, nausea, heartburn, constipation, diarrhea, black stools, metal taste

52
Q

what can iron overload do generally, and which organ is most effected

A

damage several organs, especially liver

53
Q

how can you treat Fe toxicity

A

Fe chelation

54
Q

when do you use parenteral iron therapy (3)

A

when patient cant absorb oral iron, GI surgery, GI inflammation

55
Q

what are 2 types of parenteral iron therapy

A

iron dextran IV and iron sucrose IV

56
Q

what is the structure of parenteral iron

A

central core of ferric hydroxide surrounded by carbohydrate shell

57
Q

what is the size of iron dextran or sucrose

A

varied

58
Q

what 3 things do parenteral iron therapies vary in

A

molecular size, redistribution to tissues, adverse effects

59
Q

what is the mechanism of parenteral iron therapy

A

ingested by macrophage cells which convert Fe3+ to Fe2+ferrireductases

60
Q

what is the dose of parenteral iron therapy like and why

A

slow release/ test dose for acute hypersensitivity because risk of anaphylaxis (esp. iron dextran)

61
Q

what is iron dextran vs sucrose

A

dextran is bigger

62
Q

what are some unwanted effects of parenteral iron therapy

A

pain in injected vein, flushing, nausea, hypotension, headache, myalgia, fever, anaphylaxis

63
Q

what kind of anemia would you get with NSAID induced gastritis

A

iron deficiency

PMCOL 344 (27 decks)

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