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Clinical Chem II > Trace Elements > Flashcards

Trace Elements Flashcards

1
Q

What are trace elements?

A

Inorganic micronutrients considered essential when deficiency in their intake causes impairmemt of function

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2
Q

How is function restored and symptoms alleviated when these trace elements are deficient?

A

By supplying physiological amounts of the element

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3
Q

What trace elements have specific biochemical functions and symptoms of deficiency in humans?

A 
Cupper
Zinc
Iron
Fluoride
Iodine
Chromium
Selenium
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4
Q

What is the most abundant trace element?

A

Iron (Fe)

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5
Q

What trace elements have no clear biochemical functions but are symptomatic when deficient?

A

Cobalt

Boron

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6
Q

What trace elements have a clear biochemical function but do not show symptoms in deficiency?

A

Manganese

Molybdenum

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7
Q

How are clinically critical trace elements studied primarily?

A

Via indirect measurement

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8
Q

Indirect measurement of iron

A

Hemoglobin/red blood cells appearance

Transferrin/ferritin binding/storage/transport proteins

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9
Q

Indirect measurement of iodine

A

Thyroid hormone

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10
Q

Indirect measurement of copper

A

Ceruloplasmin

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11
Q

Indirect measurement for zinc

A

RBC protoporphyrin

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12
Q

What percentage of dietary copper is absorbed?

A

50%

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13
Q

What are the functions of copper?

A

Needed in many enzyme reactions
Role in regulation of iron metabolism, formation of connective tissue, energy production within cells, and nervous system

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14
Q

Percentage of copper in liver

A

10%

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15
Q

Percentage of copper in muscle, kidney, heart, brain

A

70%

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16
Q

What protein carried copper?

A

Ceruloplasmin

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17
Q

This a-2 globulin protein made in the liver is a copper-containing enzyme that plays a role in the body’s iron metabolism.

A

Ceruloplasmin

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18
Q

What percentage of circulating copper is bound to ceruloplasmin?

A

~95%

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19
Q

Why are preemies deficient of copper?

A

Cu stores in liver increase till the third trimester.

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20
Q

What can cause cu deficiency in adults?

A

Malabsorption

Inborn error of cu absorption/metabolism

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21
Q

What disease is deficiency of cu?

A

Menke’s syndrome

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22
Q

What disease is cu overload?

A

Wilson’s disease

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23
Q

What can cause cu overload?

A

Inborn errors of cu metabolism

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24
Q

How is excess cu is usually discarded?

A

Excreted in bile to feces.

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25
Q

What organ damage is seen in cu overload?

A

Hepatolenticular degeneration.

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26
Q

What is Menke’s syndrome?

A

X-linked defect in intestinal absorption, transport and storage of cu

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27
Q

What is seen in MS?

A

Decreased cu in all compartments like hair, brain, blood, liver, kidney, skin, bone

28
Q

What are the signs and symptoms in MS?

A

Low ATP, collagen, and melanin. From childhood; growth failure, mental impairment, vascular lesions, hair and skin changes.

29
Q

What are the lab findings in MS?

A

Low tissue cu
Low serum free cu
Low ceruloplasmin

30
Q

What is Wilson’s disease?

A

Genetic defect in gene coding for enzyme responsible for cu excretion in bile/feces

31
Q

What is the pathology seen in WD?

A

Too much cu accumulated in the body
Cu deposition in liver, brain, cornea
Mental status changes(Parkinson/dementia-like)

32
Q

What lab findings are seen in WD?

A 
High tissue cu
High free serum cu
Low ceruloplasmin
High AST and ALT
Kayser/fleischer ring in the eyes
33
Q

Name other reasons for cu overload?

A

Increased synthesis of ceruloplasmin (during inflammation or consumption of oral contraceptives)
Increased intake of cu water/food)

34
Q

What is the antidote of cu overload?

A

Metal chelation agents (EDTA penicillamine, BAL)

Stomach pumping

35
Q

In what products is chromium found?

A

In meats and whole grains

36
Q

What are the functions of chromium?

A

Important in glucose and lipid metabolism
Role in cardiovascular diseases and lipid homeostasis
Potentiates insulin action, making it more efficient

37
Q

How does chromium potentiate insulin’s action?

A

By increasing insulin receptors and enhancing its binding to cells, increasing insulin sensitivity.

38
Q

Chromium is transported bound to what beta globulin protein?

A

Transferrin

39
Q

What is seen in chromium deficiency?

A

Cardiovascular disease
Impaired lipid profile
Impaired glucose tolerance and insulin resistance in some

40
Q

What is seen in chromium toxicity?

A

Respiratory tract irritation, cancer (lungs, nasal and sinus), dermatitis/ulcers
Hypoglycemia
Liver, kidney, nerve damage

41
Q

How is chromium toxicity contracted?

A

Occupational exposure (steelmaking, electroplating, leather tanning)
Hip prostheses with Cr alloy
Supplementation

42
Q

What is fluoride necessary for?

A

To support mineralization of bone and teeth

Small doses help in osteoporosis

43
Q

How does fluoride form fluorapatite in tooth enamel?

A

Fluoride ions replace hydroxyl groups in hydroxyapatite causing less susceptibility to acidic decay

44
Q

What are the signs in excessive intake of fluoride (fluorosis)

A

Mottle or pitted teeth

Possible skeletal changes and crippling calcification of ligaments

45
Q

What signs are seen in fluoride deficiency?

A

Tooth decay/dental caries

Possibly osteoporotic bone

46
Q

Where is Se present in the body?

A

All tissues

47
Q

With which vitamin is Se associated?

A

Vitamin E

48
Q

What are the functions of Se?

A

Antioxidant in protecting cells from free radicals

Thyroid gland function

49
Q

What disease is deficiency in Selenium?

A

Keshan’s disease

50
Q

What is Keshan’s disease?

A

It is selenium deficiency with mutated coxsackievirus that has resulted in endemic cardiomyopathy

51
Q

What signs are seen in se deficiency?

A

Cellular damage, immune disorder, hypothyroidism

52
Q

What signs are seen in se toxicity?

A

Garlic smelling breath, hair less, nail damage, nausea/vomiting, nerve damage

53
Q

In what type of food is zinc present?

A

All protein-rich foods

54
Q

Zn is bound to

A

Albumin and a-2 macroglobulin.

55
Q

This is an essential trace element in many metalloproteins and transcription factors like DNA/RNA polymerase, alcohol dehydrogenase, alkaline phosphatase

A

Zinc

56
Q

What are zinc fingers?

A

Important structures that interact with DNA in proteins to regulate gene expression

57
Q

What is the role of zn fingers?

A

Protein synthesis, stabilization of nucleic acids and organelles

58
Q

What are other functions of zinc?

A

In prostate gland for sperm function

Supplementation in sickle cell disease can improve lifespan of RBC and reduce vascular obstruction

59
Q

What causes zinc deficiency?

A

Decreased nutritional intake
Pregnancy (increased fetal demand)
Chronic alcoholism
Gi disease

60
Q

What are the signs in zinc deficiency?

A

Growth retardation, dermatitis, poor wound health, alopecia

61
Q

What causes zinc toxicity?

A

Acidic drinks in a zinc-coated container

62
Q

What are the signs of zinc toxicity?

A

Nausea, vomiting, diarrhea, anemia, impaired immune function.

63
Q

This an autosomal recessive disorder in which there is defective gene of a zinc transporter protein in the gut resulting in zinc deficiency

A

Acrodermatitis enteropathica

64
Q

What are the symptoms of AE?

A

Slow growth, hypogonadism, dermatological lesions, diarrhea.

65
Q

Function of Manganese

A

Enzyme activator, growth, carb and lipid metabolism

66
Q

This trace element’s only known function is its part in cobalamin/vitamin B12

A

Cobalt

Clinical Chem II (10 decks)

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