RBC Wed Prereading Flashcards

(33 cards)

1
Q

List some major sources of iron

A

red meat, shellfish, fish-heme iron

enriched cereals, beans, tofu, seeds, potatoes, green veggies, dried fruit-non heme iron

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2
Q

When are plasma hepcidin levels high?

A

when stores are full of iron and erythropoietic activity is normal

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3
Q

What does high plasma hepcidin cuase?

A

downregulation of ferroportin and trapping of most of the absorbed iron

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4
Q

When are plasma hepcidin levels low?

A

when body iron stores are depleted or erythropoiesis is stimulated

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5
Q

What happens when hepcidin leves are low?

A

ferroportin activity increases, allowing a greater fraction of absorbed iron to be transferred into plasma transferrin

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6
Q

What protein allows for entry of non-heme iron?

A

DMT-1 divalent metal transporter 1

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7
Q

What protein allows for entry of heme?

A

heme transporter

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8
Q

What cofactor is required for the asorption of non-heme iron?

A

vitamin C

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9
Q

What enzyme reduces ferric to ferrous? What is it dependent on?

A
duodenal cytochrome B
ascorbic acid (vit C)
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10
Q

What stores iron in dueodenal cells?

A

ferritin

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11
Q

What transports ferrous across the basal later membrane of duodenal cells?

A

ferroportin 1

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12
Q

What converts ferrous back to ferric once it has crossed the basal lateral membrane?

A

hephaestin

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13
Q

What molecule transports ferric in the blood?

A

transferrin

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14
Q

How do other cells take up ferric?

A

transferrin receptor–>endocytosis–>DMT1 to get out of endosome

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15
Q

What molecule regulates the release of iron from the duodenal epithelial cells?

A

hepcidin

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16
Q

What are hemosiderin granules?

A

partially degraded ferritin-iron complexes

this is the main storage form for iron during overload

17
Q

How is iron recycled?

A

by marophages

18
Q

What are major ways iron is lost?

A

shedding of intestinal/skin cells
menstruation
abnormal bleeding
pregnancy

19
Q

What is the cause of megaloblastic anemai?

A

inability to synthesize adequate amounts of purines and thymidylate triphosphate for DNA synthase
folate def, vit B12 def, methionine synthase def

20
Q

What effect does methyltrexate have on purine synthesis?

A

inhibits dehydrofolate reductase, limiting puruine and thymidylate synthesis
causes drug induced megaloblastic anemia

21
Q

Sources of folate

A

veggie (esp dark green)
fruits, grains, nuts, beans, dairy, seafood, meat
cereal, rice

22
Q

sources of vitamin B12

A

meat, shellfish, milk, eggs

vegans must get supplement

23
Q

What role does saliva play in B12 uptake?

A

Salivary haptocorrin/R protein needed

24
Q

What cells secrete intrinsic factor?

A

parietal cells

25
What is anemai caused by B12 deficiency formally called?
perniscious anemia
26
What is anemia of chronic disease (inflammation)?
mild to moderate anemia associated with inflammatory disorders, infection, malignancy
27
Common diseases associated with ACD?
chronic microbial infections chronic immune disorders Neoplasms
28
ACD features?
reduced transport of iron to erythroid precursors, reduced or ineffective erythropoiesis, normal or increased iron stores
29
Mechanism of ACD?
increased levels of IL-6 upregulares hepatic production of hepcidin, this leads to internalization nad lysosomal degradation of ferroportin and reduced release of iron into plasma
30
Blood smear in ACD?
no noticeable polychromasia or increased anisocytosis | RBCs normochromic or nomocytic
31
BM in ACD?
generally normocellular, may show diminished erythropoiesis | lack of sideroblasts
32
What happens to ferritin levels during ACD? Transferrin?
ferritin often elevated | transferrin reduced
33
Is total iron binding capacity elecated in ACD?
no