Micronutrients: Trace Elements Flashcards
(227 cards)
1
Q
Classification of Trace Elements
A
Essential
Nonessential
2
Q
if element is required for biochemical or
functional processes
A
Essential
3
Q
Essential classification is often associated with
A
Enzyme
Protein (Cofactors)
4
Q
Example of essential classification of ENZYME
A
metalloenzyme
5
Q
Example of essential classification of PROTEIN
A
metalloprotein
6
Q
may be toxic at excess
A
● Nonessential
7
Q
Nonessential classification of trace elements is also called as
A
Toxic elements
8
Q
Found in the blood in mg/L (ppm) concentration
A
Trace elements
9
Q
TRACE ELEMENTS
Found in the blood in _______ concentration
A
mg/L
Parts per million (ppm)
10
Q
Example of Trace Elements
A
Iron
Copper
Zinc
11
Q
Found in the blood in ug/L (ppb)
A
Ultratrace elemetns
12
Q
ULTRATRACE ELEMENTS
Found in the blood in _______
A
ug/L
Parts per billion
13
Q
Example of Ultratrace elements
A
Selenium
Chromium
Manganese, etc.
14
Q
Enumerate all Trace Elements
A
- Iron
- Copper
- Zinc
- Chromium
- Cobalt
- Fluoride
- Manganese
- Molybdenum
- Selenium
- Mercury
- Lead
- Aluminum
- Arsenic
- Cadmium
15
Q
A common metallic element important for the
synthesis of ________
A
IRON
hemoglobin
16
Q
Ferroprotoporphyrin requires _____ to form
_________ (heme)
A
IRON
Iron
ferroprotoporphyrin 9
17
Q
Carrier of other biochemically active substances
A
IRON
18
Q
Example of biochemically active substances
A
Oxygen
19
Q
An agent in redox and electron transfer reactions
A
IRON
20
Q
Total body iron _____________
A
3-5 g
21
Q
TOTAL BODY IRON
______ - hemoglobin
A
2 - 2.5 g
22
Q
TOTAL BODY IRON
________ – myoglobin
A
~ 130 mg
23
Q
TOTAL BODY IRON
_____ – enzymes
A
8 mg
24
Q
TOTAL BODY IRON
______ – plasma
A
3 - 5 mg
25
TOTAL BODY IRON
Iron can also bind in these not just plasma
transferrin
albumin
free hemoglobin
26
Storage form of iron
Ferritin
27
Iron from food (_______) are typically in their
_______ (Fe3+)
dietary iron
ferric state
28
Fe3+ are (readily/not readily) absorbable, they
should be ________ first
not readily
reduced
29
only _____ of dietary iron is absorbed
10%
30
Substances (such as ______) or __________
by reduces Ferric ions to ____________
Vit. C
Ferric reductase
Ferrous iron
31
_________ readily absorbable iron by the _______________ and are stored in the cell in the form of ___________
Fe2+ (Ferrous iron)
intestinal mucosal cells
Ferritin
32
stored form of iron
Ferritin
33
Iron in Ferritin has how many fates?
two
34
If the body needs iron:
_____ in the cells will (release/absorb) the Iron into the circulation
ferritin
release
35
In the circulation, it will be _______ again (Fe2+) to _______
oxidized
Fe3+ (Ferric ion)
36
Ferric iron will be bound to
____________
transferrin
37
What is the iron transporter
Transferrin
38
T/F: after ferric iron is bound to transferrin, it will be transported to specific organs of the body
F; all throughout the body
39
If the body does not need iron:
excreted in ______ of ________________
desquamation of intestinal cells
40
Enumerate the condition/ where there is DECREASE in iron
● Iron Deficiency Anemia
● Malnutrition
● Malignancy
● Chronic infection
● Nephrotic syndrome
41
Enumerate the condition/ where there is INCREASE in iron
● Primary hemochromatosis
● Sideroblastic anemia
● Hemolytic anemia
● Liver disease
42
Enumerate the Laboratory Evaluation tests used in Iron
1. Hematologic Tests
2. Total Iron Content (Serum Iron)
3. Total Iron Binding Capacity (TIBC)
4. Percent Saturation
5. Transferrin
6. Ferritin
43
Enumerate the different Hematologic Tests
Packed Cell Volume
Hemoglobin
RBC count and indices
44
Packed cell volume is also called as
Hematocrit
45
Refers to Fe+3 bound to transferrin
Total Iron Content (Serum Iron)
46
Specimen used in Total Iron Content (Serum Iron)
Serum; or
Heparinized Plasma
47
Variables in Total Iron Content (Serum Iron)
→ Hemolysis
→ Other anticoagulants
→ Diurnal variation
48
What are the other anticoagulants in the variables of IRON
oxalate
citrate
EDTA
49
DIURNAL VARIATION (Iron)
preferred time of collection
Early Morning
50
Method used in Total Iron Content (Serum Iron)
→ Colorimetric
→ Anodic Stippling Voltammetry
51
What is used in Colorimetric Method of Total Iron (Serum Iron)
HCL
Ferrozine
52
● Amount of iron that can saturate transferrin
Total Iron Binding Capacity (TIBC)
53
Measures the amount of binding site present in
transferrin
Total Iron Binding Capacity (TIBC)
54
Measures the amount of ________ present in
_________
TOTAL IRON BINDING CAPACITY (TIBC)
binding site
transferrin
55
What is added in Saturate transferrin in TIBC
MgCO3
56
TIBC
Add Iron in to the Plasma/ serum containing
________ then _________
transferrin
measure Iron
57
TIBC
__________ will bind the added Iron until all
transferrin are __________
Transferrin
saturated
58
TIBC
The remove excess Iron, add MgCO3
(_______________)
Then ______________
Magnesium carbonate
measure Iron again
59
Increased TIBC:
_____ (↓ ______)
iron deficiency anemia
Fe2+
60
Decreased TIBC:
__________ (↑ __)
hemochromatosis
Fe
61
Reference value of TIBC
250 - 425 ug/dL
62
a.k.a Transferrin saturation
Percent Saturation
63
● Ratio of serum iron to TIBC
Percent Saturation
64
Percent Saturation is the ration of ________ to _______
Serum iron
TIBC
65
Formula for Percent Saturation
di ko malagay
%saturation = (serum iron/TIBC)x100
66
Reference value of Percent Saturation
20 - 50%
67
INCREASED Percent Saturation is seen in
hemochromatosis
sideroblastic anemia
68
DECREASED Percent Saturation is seen in
Iron Deficiency Anemia
69
Iron transport protein
Transferrin
70
Apotransferrin + Iron
Transferrin
71
TRANSFERRIN
___________ + ___________
Apotransferrin
Iron
72
Reference value of Transferrin
200 - 300 mg/dL
73
INCREASED transferrin is seen in
Iron deficiency anemia
74
DECREASED Transferrin is seen in
Hemochromatosis
75
Laboratory method for Transferrin
Immunochemistry (nephelometry)
76
Storage form of Iron
Ferritin
77
Rough estimate of body iron content
Ferritin
78
FERRITIN RV
Male
20 - 250 ug/L
79
FERRITIN RV
Female
10 - 120 ug/L
80
FERRITIN RV
Increased in:
Hemochromatosis
81
FERRITIN RV
Decreased in
Iron deficiency anemia
82
Laboratory method for Ferritin
Immunochemistry
83
Component of several metalloenzymes
Copper
84
Critical for the reduction of iron in heme synthesis
Copper
85
Critical for the reduction of iron in _______
COPPER
heme synthesis
86
Readily absorbed by the body
COPPER
87
Presence of _____ can decrease intestinal
absorption of _____
zinc
copper
88
copper-binding protein (enzyme)
Ceruloplasmin
89
COPPER
Distribution: : ________ (total copper)
50 - 120 mg
90
COPPER
Distribution (organs)
Liver, brain, heart, and kidneys
cornea, spleen, intestine, and lungs.
91
DISTRIBUTION OF COPPER
Small amounts can be found in
cornea, spleen, intestine, and lungs.
92
COPPER
Distribution in Liver how many percent
10%
93
RV COPPER
70 - 140 ug/dL
94
RV COPPER
Decreased in:
Menkes disease
95
Menkes disease characteristics
kinky/steely hair,
growth retardation
96
RV COPPER
Increased:
Wilson’s disease
97
copper accumulation disorder
Wilson’s disease
98
Wilson's Disease
___________________ in the cornea
Kayser-Fleischer Rings
99
fatal progressive brain disease characterized of having a peculiar hair
● Menkes disease
100
Wilson's disease
(inc/dec) copper = (inc/dec) ceruloplasmin
increased copper
decreased ceruloplasmin
101
treatment against copper overdose
Penicillamine
102
2nd trace element in terms of importance
ZINC
103
If zinc is the 2nd trace element in terms of importance, what is 1st?
Iron
104
Functions of Zinc
→ Influences more than 300 enzymatic reactions
→ DNA, RNA, and protein synthesis and metabolism
→ Glucose and cholesterol metabolism
→ Insulin function
→ Growth factor effects
105
● Used as treatment for Wilson’s disease (↑ Cu)
Zinc
106
ZINC
● Used as treatment for _______________ (↑ Cu)
Wilson’s disease
107
Why is zinc used as treatment for Wilson's dx
Can impair/ decrease absorption of copper
108
Source of Zinc
: Almost exclusive to animal products
109
Absorption of Zinc
Jejunum
110
Where is Zinc distrubuted
Blood
111
ZINC
Distribution: RBC
80%
112
ZINC
Distribution: Plasma
17%
113
ZINC
Distribution: WBC
3%
114
Excretion of Zinc
Feces (90%)
115
____ - color (makes rubies red and emeralds
green)
Chroma
116
Valency states of Chromium
→ Trivalent [Cr(III)]
→ Hexavalent [Cr(VI)]
117
Valency states of Chromium
essential dietary element
Trivalent [Cr(III)]
118
Valency states of Chromium
Maintains normal glucose, fat and
cholesterol metabolism
Trivalent [Cr(II)]
119
CHROMIUM
Trivalent [Cr(III)] is DECREASED in
✓ Glucose intolerance
✓ Glycosuria
✓ Hypercholesterolemia
✓ Decreased longevity
✓ Decreased sperm count
✓ Impaired fertility
120
Valency states of Chromium
Toxic agent
Hexavalent [Cr(VI)]
121
A respiratory tract irritant
Hexavalent [Cr(VI)]
122
May induce cell death
Hexavalent [Cr(VI)]
123
Integral part of Vitamin B12
COBALT
124
Cobalt is Integral part of ________
Vitamin B12
125
T/F Cobalt has NO other known function
T
126
COBALT
Increased (kidneys)
Hypoxia-Inducible Factor
127
cause release of ___________ resulting to (inc/dec)
erythropoiesis
Hypoxia-Inducible Factor
erythropoietin
increased
128
cause release of ___________ resulting to (inc/dec)
erythropoiesis
Hypoxia-Inducible Factor
erythropoietin
increase
129
Most widely used “pharmacologically beneficial trace
elements”
FLUORIDE
130
Fluoride is widely used "_________________________"
“pharmacologically beneficial trace elements”
131
● Exchanged for _________ in ______
FLUORIDE
hydroxyl
apatite
132
Main component of skeletal bone and teeth
Apatite
133
Apatite in ______ contains __________, when
you use toothpaste with Fluoride, these
OH are replaced with __________
teeth
OH group
Fluoride
134
Stabilizes the regenerating tooth surface.
Apatite
135
FLUORIDE
Increased in
Dental Fluorosis
136
mottling of enamel in the erupting teeth of children
Dental Fluorosis
137
Fluoride
To prevent Dental Fluorosis, use _________
Pediatric toothpaste
138
why is pediatric toothpaste used for remedy in Dental Fluoorosis
(has low Fluoride content
139
Constituent of metalloenzymes and an enzyme
activator
Manganese
140
Normal component of tissues
Manganese
141
Highest levels of Manganese is found in:
Fats; and
Bones
142
RV MANGANESE
Serum
0.5 - 1.3 ug/L
143
What is used in serum collection for Manganese
plastic cannula/canullae
144
RV MANGANESE
Whole blood
5 - 15 ug/L
145
Manganese is DECREASED in:
impaired growth
skeletal abnormalities
epilepsy
146
Manganese
INCREASED
resembles Parkinson’s Disease
147
manganese madness
“locura manganica"
148
acute manganese aerosol intoxication
“locura manganica" (manganese madness)
149
This is included in these three enzymes
Xanthine oxidase
aldehyde oxidase
sulfite oxidase
Molybdenum
150
Three enzymes where molybdenum is included
Xanthine oxidase
aldehyde oxidase
sulfite oxidase
151
Active sites of the three enzymes
binds molybdopterin (cofactor)
152
MOLYBDENUM
Blood: bound to _________ and ____________
α2-macroglobulin
RBC membranes
153
T/F: Molybdenum can cross the placenta
T
154
Mothers with (high/low) molybdenum diet can also
(elevate/decrease) _____________________
high
elevate
neonatal hepatic molybdenum
155
RV MOLYBDENUM
Serum
0.5 ug/L
156
RV MOLYBDENUM
Whole blood
1 ug/L
157
RV MOLYBDENUM
Urine
40 - 60 ug/L
158
SELENIUM
1930s
Toxic element
159
SELENIUM
1940s
Carcinogen
160
SELENIUM
1950s
Essential element
161
SELENIUM
1960s-1970s
Anti-carcinogen
162
component of numerous biological proteins
Selenocysteine
163
biologically active form of selenium
Selenocysteine
164
Example of biological proteins composed with Selenocysteine
Glutathione peroxidase
165
cellular antioxidant defense system
Glutathione peroxidase
166
carcinogenic form of selenium
Selenium sulfide
167
SELENIUM
Decreased in:
cardiomyopathy
skeletal muscle weakness
osteoarthritis
168
DEC. SELENIUM
endemic cardiomyopathy
Keshan Disease
169
Common among children & women of
child-bearing age
Keshan Disease
170
DEC. SELENIUM
endemic osteoarthritis
Kashin-Beck Disease
171
Common among adolescence
Kashin-Beck Disease
172
SELENIUM
Increased in
dermal effects
neurologic problems
173
Mercury a.k.a
“quick silver”
174
liquid at _____________
quick silver
room temperature
175
What are the elements that is liquid @ RT
Mercury
Bromine
176
T/F: Mercury has NO physiologic function
T
177
Oxidation states of Mercury
○ Hg(0)
○ Hg(+1)
○ Hg(+2)
178
MERCURY
Routes of exposure
→ Inhalation
→ Ingestion
→ Cutaneous
→ Injection
→ Dental amalgams
179
ROUTES OF EXPOSURE - MERCURY
Inhalation - ___________
○ __________ are retained in the _________
elemental mercury vapor
80%
lungs
180
ROUTES OF EXPOSURE - MERCURY
Ingestion - ______________
○ Much (dangerous/safer) because mercury is (absorbed/not absorbed) by the body
mercuric chloride
safer
Not absorbed
181
ROUTES OF EXPOSURE - MERCURY
Cutaneous - __________
methylmercury
182
ROUTES OF EXPOSURE - MERCURY
Injection - __________________
tattoo pigment with mercury
183
ABSORPTION MERCURY
→ Storage organ: _______
Kidney
184
Soft, bluish white, highly malleable and ductile metal
LEAD
185
May interfere with _________
LEAD
heme synthesis
186
Lead interferes with heme synthesis by causing:
Basophilic stippling
Cabot rings
187
blueberry bagel appearance of RBC
Basophilic stippling
188
ABSORPTION OF LEAD
→ ______ (____) and _____________
→ ______ is taken up by ______
Respiratory
30-40%
Gastrointestinal
90%
RBC
189
LABORATORY ANALYSIS OF LEAD
Method
Blood lead level
190
LABORATORY ANALYSIS OF LEAD
Specimen
Whole venous blood
191
Most abundant metal in earth’s crust
Aluminum
192
Always combined with other elements
Aluminum
193
What are the elements Aluminum is always combined with?
→ Oxygen
→ Silicon
→ Fluorine
194
ABSORPTION OF ALUMINUM
__________ (______); and
______ (______)
Respiratory
1.5-2%
GI tract
0.01-5%
195
Aluminum is bound to ____ in blood
transferrin
196
ALUMINUM DISTRIBUTION
→ Bone
→ Lungs
197
ALUMINUM DISTRIBUTION
Bone %
50%
198
ALUMINUM DISTRIBUTION
Lungs %
35%
199
ALUMINUM EXCRETION
→ Urine
→ Bile
200
ALUMINUM EXCRETION
Urine %
95%
201
ALUMINUM EXCRETION
Bile %
2%
202
Aluminum is INCREASED in:
Encephalopathy
osteomalacia
aplastic bone disease
myopathy
microcytic anemia
203
largest source of arsenic exposure
FOOD
204
Food – largest source of _______
arsenic exposure
205
Before, Arsenic is considered as ______
terorrist agent
206
Arsenic example
Arsenic trioxide
207
One of the most common poisons in human
history
Arsenic trioxide
208
treatment for acute promyelocytic leukemia (US
FDA)
Arsenic trioxide
209
Arsenic trioxide is treatment for ___________________
acute promyelocytic leukemia
210
Arsenic trioxide as treatment for promyelocytic leukemia is approved by _______
US FDA
211
ARSENIC
Toxic dose
: 0.01 - 0.05 g
212
ARSENIC
Lethal dose
0.12 - 1.3 g
213
ARSENIC
Antidotes
Chelators
214
Example of chelators for Arsenic
Dimercaprol
Penicillamine
Succimer
215
Dimercarpol a.k.a
BAL - British Anti-Lewisite
216
- form of arsenic
Lewisite
217
Arsenic poisoning (Odor of Breath):
Garlic
218
Preferred sample for Arsenic
Urine
219
T/F: Urine has shorter half-life than blood
F; longer half-life
220
T/F: Cadmium has NO knows physiologic function
T
221
Most absorbed cadmium are found in _____
RBC
222
How many percent of cadmium is found in RBC
70%
223
ABSORPTION OF CADMIUM
→ Respiratory
→ Gastrointestinal
224
ABSORPTION OF CADMIUM
→ Respiratory (_____)
→ Gastrointestinal (______)
10 - 50%
5%
225
EXCRETION OF CADMIUM
Feces (90%)
226
CADMIUM
TOXICITY: _____________________ causing
____________ of the __________ (losing its
function)
Protein-Cadmium complex
denaturation
associated protein
227
Enumerate the different Hematologic Tests
Packed Cell Volume
Hemoglobin
RBC count and indices
