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CLS 307 > Lecture 9 Chapter 17 > Flashcards

Lecture 9 Chapter 17 Flashcards

1
Q

Reasons there’s increased need of iron/blood

A

Vegan
Pregnant
Heavy menstruation
Chronic loss I.e. GI bleeding
Impaired absorption due to pH levels in stomach and the intestines environment

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2
Q

What is the marrow iron rating in a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia?

A

2-3+
0-1+
0
0

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3
Q

What is the serum Fe level in a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia am?

A

150 micrograms/dL
120 micrograms/dL
<100 micrograms/dL
<20 micrograms/dL

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4
Q

What is the % saturation in a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia am?

A

40%
35%
<30%
<20%

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5
Q

What is the hematocrit % in a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia am?

A

45%
45%
41%
<40%

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6
Q

What is the RBC morphology of a normal cell, iron depleted cell, iron deficient erythropoiesis cell, and iron deficieny anemia am?

A

Normal
Normal
Normal
Microcytic hypochromic

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7
Q

What is the normal range of % saturation

A

20-55%

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8
Q

What is the morphology of RBCs in chronic anemia cases?

A

Microcytic
Hypochromic

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9
Q

Groups more at risk of iron deficiency anemia

A

Pregnant women
Vegans
Genetic
Women with heavy periods

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10
Q

Groups less at risk of iron deficiency anemia

A

Adult males

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11
Q

Factors increasing risk of iron deficiency anemia

A

Pregnant
Heavy menstruation
Age

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12
Q

Diagnostic tests for iron deficiency anemia

A

Serum iron
Total iron-binding capacity (TIBC)
Transferrin saturation
Ferritin

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13
Q

Label

A

From top down:
Unsaturated iron binding capacity (UIBC)
Total iron binding capacity (TIBC)
Serum iron (S.I.)

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14
Q

% Transferrin saturation =

A

(Serum iron concentration/TIBC)*100

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15
Q

What does free protoporphyrin bind to

A

Zinc

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16
Q

What is an acute phase reaction

A

A protein
Inflammation/infection/chronic disease effect the levels of it
They are either positive or negative

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17
Q

Examples of proteins that have a positive level or increase due to an acute phase reaction

A

Ferritin
hepcidin

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18
Q

Examples of proteins that have a negative level or decrease due to an acute phase reaction

A

Transferrin
Albumin

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19
Q

What does bacteria need to replicate

A

Ferritin/iron

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20
Q

How does your body respond to a bacterial infection

A

Your body makes more ferritin and has it bind to iron so the bacteria cannot bind and divide
Transferring goes down so you don’t transfer iron while bacteria is trying to divide

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21
Q

What happens when there is not enough iron to bind with protoporphyrin

A

The protoporphyrin will bind to zinc and levels of zinc and free protoporphyrin in the blood will increase

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22
Q

What organ produces serum transferrin receptors

A

Liver

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23
Q

Levels of serum transferrin increase when ______, and decrease when ______

A

There is not enough iron
There is too much iron

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24
Q

What test can provide a final answer or confirm a suspicion

A

Bone marrow evaluation (biopsy/aspiration)

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25
Study
26
Describe the path of iron from a macrophage
Transferrin binds to iron → delivers to the bone marrow → hepcidin traps iron
27
Anemia of chronic disease is the disease of
Iron transportation
28
Cell morphology for anemia of chronic disease
Mild microcytic Mild hypochromic
29
Causes of anemia of chronic disease
Chronic infections, inflammations, malignancy and anemia of renal disease
30
What is the origin of anemia
Lack of transportation of iron, or not enough iron
31
When you have an inflammation, your immune cells, _____, ______, and _______ release _____ and increases the expression of ______
B lymphocytes T lymphocytes Macrophages Interlucin 6 Hepcidin
32
Diagnosis of anemia of chronic disease based on
Degree of anemia Classification of anemia (microcytic/hypochromic) WBC and platelet counts increase Mcv= lower end of spectrum 80-100 Iron level may be normal or in range Serum-transferring receptors
33
Siderocytes/ringed sideroblasts
34
What color does perl's stain make iron
Green/blue
35
What is the cause of sideroblastic anemia
Iron disorder; has to do with the production of protoporphyrin
36
What are pappenheimer bodies?
Iron deposits
37
Succinyl CoA generates what
Porphryn
38
Porphyry goes through 6-7 enzymatic cells to create
Protoporphryn IX
39
Where does protoporphryn IX go after getting created
Goes to mitochondria of a normoblast and get incorporated into iron and that creates heme
40
If hereditary,if there is a mutation in any of the proteins that are involved in the function of the 6 enzymes porphryn goes through to become protoporphryn IX you will develop
Byproducts, each having a different effect
41
Porphyria's
A collective group of diseases Very heterogenous
42
Pyphyrias are a
Neurological disorder Cause pathological conditions Turns urine red due to the byproduct of free metabolism Accumulates in skin and every tissue
43
What happens when you have porphyria and go into the sunlight
The periphery molecules absorb the UV light Can cause blistering/burning
44
With porphyria you cannot
Make protoporphryn IX → cannot make heme → cannot make hemoglobin → anemia → microcytic and hypotrophic
45
Which anemia has to be confirmed by bone marrow
Sideroblastic anemia
46
What is the cause of sideroblastic anemias
Production of protoporphryn
47
If you do not have enough protoporphry….
Iron will deposit in normoblasts
48
What is the most common material that causes an acquired sideroblastic anemia
Lead/heavy metal poisoning
49
Characteristics of lead/heavy metal poisoning
Attacks nervous system/brain, permanent damage Most common among children Can see iron deposits with Perl stain
50
Nucleated RBCs
51
Label
Top to bottom: Granules nRBC Siderocyte Pappenheimer bodies
52
Treatment for sideroblastic anemias
Remove the cause Chelation of lead
53
What is hereditary hemochromatosis
Iron overload due to genetics
54
What is the Fenton reaction
Iron has a tendency of generating free radicals such as O2 and OH that bind to proteins in nucleic acids and lipids
55
Free radicals damage what
Every organic compound in the body
56
How harmful is iron overload
Very harmful, but can take 10-20 years to develop
57
If iron deposits accumulate in your heart when you develop iron overload you will get
Cardiomyopathy
58
If iron deposits accumulate in your pituitary glands when you develop iron overload you will get
Endocrine forms
59
If iron deposits accumulate in your liver when you develop iron overload you will get
Liver cirrhosis
60
If iron deposits accumulate in your kidney when you develop iron overload you will get
Renal failure
61
What is the HFE gene
A gene that is mutated in various hemochromatosis
62
What does it mean when your liver turns a rusty brown color
Hepatocytes dying
63
What disease causes excessive iron accumulation in the liver from the gut due to abnormal absorption of normal iron intake resulting in organ dysfunction
Autosomal recessive hemochromatosis
64
What disease does iron overload from any other cause such as frequent transfusions or dietary overconsumption
Hemosiderosis
65
What does HFE protein do
Controls the expression of the gene for hepcidin
66
Heparin expression goes
Up when too much iron Down when too little iron
67
What happens when you have a mutation in the HFE
Cannot make the right HFE protein Cannot control process so level of hepeidin will always be down As iron gets absorbed, the hepathocytes will induce HFE gene to produce hepcidin Hepcidin inhibits iron absorption Cannot make hepcidin expression go up due to mutation So hepcidin is always off You absorb more than 1-2mg per day
68
What is an example of acquired iron overload
When someone needs to get blood transfusions due to an issue with their lifespan of RBCs Transfusions contain 250mg of iron plus their diet
69
If you find a mutation in the HFE gene, that tells you its what diagnoses
Hereditary hemochromatosis
70
Hemochromatosis is _______ which means it must have _____ gene mutations
Autosomal recessive 2

CLS 307 (21 decks)

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