TRACE METALS Flashcards
1
Q
TRACE ELEMENTS
Associated with
A
enzymes or proteins
2
Q
Essential: deficiency impairs a biochemical or functional process
A
TRACE ELEMENTS
3
Q
The essential trace elements are usually associated with enzymes and serves as (?) in enzymatic reactions.
A
cofactor
4
Q
An element is to be considered (?) if the deficiency impairs a biochemical or functional process and replacement of the impairment corrects this impairment.
A
essential
5
Q
Laboratory determination
A
Anti-coagulated blood
6
Q
Ideal:
A
anticoagulated blood samples
7
Q
Low concentration in the plasma and ubiquitous nature
A
TRACE ELEMENTS
8
Q
Prevent contamination
A
TRACE ELEMENTS
9
Q
Method of choice:
A
Atomic absorption spectrophotometry
10
Q
Most abundant trace element in the body wherein about 40 to 50 mg of iron is present per kilogram body weight
A
Iron
11
Q
Iron containing proteins are important in the metabolism such as
A
collagen, tyrosine and catecholamines
12
Q
of iron is imp for Hb synthesis
Anemia
A
30%
13
Q
is the second most abundant trace metal in the body and is known to be a cofactor for almost 300 enzymes
A
Zinc
14
Q
Zinc Essential in the:
A
- Structure
- Regulation
- Catalytic activity of 300 enzymes
15
Q
important in the synthesis and metabolism of RNA and DNA
A
Zinc
16
Q
Zn plays a role in the synthesis, (?) as well as in (?), the decrease in Zn will affect the ability of the islet cell to produce and secrete insulin, that may contribute to the development of Type 2 diabetes
A
storage and secretion of insulin
conformational integrity of insulin
17
Q
• Hormone produced by the pancreas to regulate blood sugar
A
INSULIN
18
Q
• Associated with Type 2 diabetes
A
INSULIN
19
Q
is the third most abundant trace metal in the body
A
Copper
20
Q
Cu Sources :
A
shellfish, liver, nuts and legumes
21
Q
Cu Dietary requirement:
A
1.5-3.0 mg/day
22
Q
Participates in:
A
- Cellular respiration
- DNA & RNA reproduction
- Maintains cell membrane integrity
- Sequestration of free radicals
23
Q
: unstable atoms that can damage cell causing cell to age
A
free radicals
24
Q
Iron majorly found in the following:
A
Hemoglobin synthesis in RBC
Ferritin and hemosiderin
myoglobin and non heme enzymes
25
– most imp use of iron in the body
Hemoglobin synthesis in RBC
26
as iron stores
Ferritin and hemosiderin
27
Moderate amount is found in body tissue such as
myoglobin and non heme enzymes
28
Iron bound to (?) which is the first to become diminished in iron deficiency conditions
transferrin
29
blood plasma glycoprotein playing a central role iron metabolism; delivers/transfers iron
transferrin
30
Iron Dietary iron:
ferrous form (Fe2+) for absorption
31
Primary regulation:
absorption thru the intestines
32
present in the food
Ferric form (Fe3)
33
Cannot be absorbed in the intestines
Ferric form (Fe3)
34
Iron absorption facilitated by
Ascorbic acid & other reducing agents
acid pH in the stomach
35
- glycoprotein that transports Iron
Transferrin
36
measure of plasma transferrin level (NV: 56 mol/L)
Total Iron Binding Capacity
37
best to measure blood’s ability to attach itself to iron and transport iron around the body
Low iron level = anemia
Total Iron Binding Capacity
38
- found virtually in all cells
Ferritin
39
Iron store: synthesis of iron-containing compounds
Increased serum ferritin:
Fever
Acute infections
Rheumatoid arthritis
Viral hepatitis
40
is mainly absorbed from the duodenum.
Zinc
41
Zinc is mainly absorbed from the.
duodenum
42
In blood, bound to (?)
albumin and α-2 macroglobulin
43
(?) contain most of the body’s Zn stores.
bones and the muscle
44
slow turnover (half-life of ?)
300 days
45
In the liver, zinc is bound to (?).
metallothionein
46
: zinc transporter protein
METALLOTHIONEIN
47
METALLOTHIONEIN half-life is
~2 weeks
48
Zn Dietary Sources:
o Oyster
o Lamb meat
o Beef
o Seafoods (crab, lobsters)
o Cashew
o Cheese and dairy products
o Beans and legumes
49
- highest copper concentration
Liver
50
-containing proteins
Copper
51
- synthesized in the liver Cu
Ceruloplasmin
52
-bound Cu
Albumin
53
- transporter protein Cu
Transcuperin
54
- sequesters and stores copper Cu
Metallothionein
55
1. Iron depletion
Iron Deficiency
56
2. Iron Deficiency Anemia
Iron Deficiency
57
Blood loss due to GI bleeding
Iron Deficiency
58
Chronic drug ingestion
Iron Deficiency
59
Parasitic infection
Iron Deficiency
60
Impaired absorption of iron
Iron Deficiency
61
Renal failure
Iron Deficiency
62
Iron Overload Common causes:
Hereditary hemochromatosis
63
Hereditary hemochromatosis
Iron Overload
64
Sideroblastic anemia
Iron Overload
65
Chronic ingestion of medicinal iron
Iron Overload
66
Chronic hepatitis
Iron Overload
67
Diabetes mellitus
Zinc deficiency
68
Alcohol abuse
Zinc deficiency
69
Malabsorption syndrome
Zinc deficiency
70
Liver and kidney disease
Zinc deficiency
71
Acrodermatitis enteropathica
Zinc deficiency
72
Common among premature infants and undernourished children
Copper deficiency
73
related to malnutrition, malabsorption, and chronic diarrhea and prolonged feeding with low-copper, total-milk diets
Copper deficiency
74
Cu main cause:
low-copper diet (milk)
75
Cu Contributing factor in adults:
1. osteoporosis/ bone&joint abnormality
2. Cardiovascular disease /Coronary Heart Disorders(CVD)
76
Menke's disease or "kinky hair syndrome
Copper deficiency
77
Menke's disease or "kinky hair syndrome Clinical features:
• Diminished copper conc. in hair
• Decrease in ceruloplasmin
• peculiar hair/stilly hair
78
Increased tissue and serum levels
Copper toxicity
79
Mostly caused by Acute copper poisoning coming from fungicides
Copper toxicity
80
WILSON'S DISEASE
Copper toxicity
81
WILSON'S DISEASE Triad of Manifestations:
Neurologic disorders
Liver dysfunction
Kayser-Fleischer rings
82
composed of diff mental signs and symptoms; caused by accumulation of cu+ in the brain (symptoms: Alzheimer’s, dementia, hallucination, schizophrenia)
Neurologic disorders
83
: sequestration of drugs For bilirubin metabolism and sequestration of drugs
Liver dysfunction
84
Liver
Liver dysfunction
85
green-brown discoloration in the cornea
Kayser-Fleischer rings
86
Decreased release of ferritin
Iron Deficiency
87
Most serious cause of GI bleeding:
Hookworm anemia
88
Hookworm:
Bites in the walls of SI
Necator americanus
89
Kidney disease
EPO - synthesized in the kidney; imp for rbc devt
Iron Deficiency
90
The following shows symptoms of hemochromatosis
1. Hereditary hemochromatosis
91
is a disorder that causes the body to absorb too much iron from the diet. Sideroblastic anemia, Chronic ingestion of medicinal iron, Chronic hepatitis
Hereditary hemochromatosis
Sideroblastic anemia
Chronic ingestion of medicinal iron
Chronic hepatitis
92
most common cause of iron overload
1. Hereditary hemochromatosis
93
1. Hereditary hemochromatosis
caused by accumulation of iron in the
liver and skin
94
causes hyperpigmentation of the skin
1. Hereditary hemochromatosis
95
BM produces ringed sideroblasts
Sideroblastic anemia
96
Hepa C infection
Chronic hepatitis
97
causes reduction in the effects of antiretroviral drugs
Chronic hepatitis
98
– low zinc and insulin levels
Diabetes mellitus
99
– Cofactor of Alcohol Dehydrogenase (function by the liver)
Alcohol abuse
100
develops among infants; facial rash with diaper rash
Acrodermatitis enteropathica
101
prominent observable feature
Menke's disease or "kinky hair syndrome
102
form of extreme def in cu+ observed among newborns and babies
Menke's disease or "kinky hair syndrome
103
problem in the absorption of cu
Menke's disease or "kinky hair syndrome
104
affects both mental and physical retardation
Menke's disease or "kinky hair syndrome
105
severe cases: weak muscle tone (hypotonia); sagging features
Menke's disease or "kinky hair syndrome
106
- agricultural workers/infestations control; inhalation of mist containing cu+ sulfate
fungicides
107
– most important genetically determined copper accumulation disease
WILSON'S DISEASE
108
Copper deposits in tissues liver, brain & corned)
WILSON'S DISEASE
109
quantitative, specific, & sensitive
Direct measurements
110
involve invasive procedures
111
is digested and analyzed for iron
Liver biopsy
112
is used as a substitute for biopsy in monitoring iron overload
quantitative phlebotomy
113
Examples of Fe Direct measurements
1. Quantitative phlebotomy
2. Bone marrow biopsy
3. Liver biopsy
114
- performed if liver biopsy is not available; to document iron overload
1. Quantitative phlebotomy
115
1. Fe Quantitative phlebotomy
(?) phlebotomies
(?) mL (1 blood bag)
16 to 20
450
116
digested and analyzed for iron; first option
Liver biopsy
117
Fe Indirect methods Serum iron is measure by:
1. Colorimetric method
2. AAS
118
- Zinc is highest in the morning.
Diurnal variation
119
- Zinc is highest when fasting;
Postprandial variation
120
Serum values 10% greater than plasma values
Postprandial variation
121
The RBC has (?) more zinc than the plasma hence hemolysis should be avoided.
10x
122
The reference method for zinc measurement is.
AAS
123
Other methods (Not usually used for medical purposes; tedious):
1. Flame Atomic Absorption Spectrometry (FAAS)
2. Inductively coupled plasma - mass spectrometry (ICP-MS)
124
- method of choice for Zn in body fluids
1. Flame Atomic Absorption Spectrometry (FAAS)
125
- reference Testing method in serum or plasma
2. Inductively coupled plasma - mass spectrometry (ICP-MS)
126
Serum or urine copper can measure using (?) which is the method of choice or
AAS
colorimetric method.
127
Ceruloplasmin is measured by
photometric method and immunochemical methods.
128
Total Fe++:
60 – 150 µg/dL
129
TIBC:
250 – 400 µg/dL
130
Iron Sat’n:
20 – 55%
131
Ferritin:
Male: 15 – 200 µg/L
Female: 12 – 200 µg/L
132
Zn PLASMA REFERENCE VALUE:
70 - 120 g/dL (10.7 - 18.4 pmol/L)
133
Serum Copper
Male: 70 – 140 µg/dL (11 – 22µmol/L)
Female: 80 – 155 µg/dL (13 – 24µmol/L)
134
Ceruloplasmin:
23 – 50 mg/dL
135
Constituent of vitamin B12
Cobalt
136
Folate metabolism
Cobalt
137
Erythropoiesis
Cobalt
138
Toxic at high doses
Cobalt
139
Cobalt Laboratory determination :
AA'S
140
Naturally occurring; industrial waste
Chromium
141
Chromium: rich sources
Meat and grains
142
Chromium
Once absorbed, transported to the tissue by
transferrin
143
Chromium In glucose metabolism:
Insulin cofactor
144
Chromium Deficiency :
insulin resistance
145
Chromium supplementation:
improved glucose tolerance, reduced insulin concentrations, decreased total cholesterol
146
Prevention of dental caries
Fluoride
147
Fluoride Excess:
mottling of teeth and calcification in soft tissues
148
Minimize bone loss or stimulate bone formation
Fluoride
149
Readily absorbed by the gut and distributed almost totally to the bone and teeth
Fluoride
150
Fluoride Laboratory determination:
ISE
151
Manganese
Activator of several enzyme systems Ex:
Arginase, pyruvate carboxylase, superoxide dismutase
152
Manganese
Transported in plasma by
albumin, a2-macroglobulin and transferrin
153
Manganese Deficiency :
seizures and epilepsy (rare)
154
Manganese Excess:
Locura manganica
155
Manganese madness
Locura manganica
156
First discovered among children in some parts of south America
Locura manganica
157
Inhalation of Mg from aerosol gases in mines
Locura manganica
158
Molybdenum
Essential cofactor for several
oxidase enzymes
159
: Converts hypoxanthine to uric acid
Xanthine DH/xanthine oxidase
160
: Catalyzes conversion of acetyl-CoA to acetate
Aldehyde oxidase
161
: Converts sulfite to sulfate
Sulfite oxidase
162
Molybdenum is mostly absorbed in
stomach and small intestines
163
inhibit Molybdenum absorption
Copper and iron
164
Molybdenum Excess :
inhibition of copper dependent enzymes (ceruloplasmin-or cytochrome oxidase)
165
Molybdenum Excess:(Facilitates conversion of hypoxanthine to uric acid)
hyperuricemia and gout
166
Selenium
Cofactor in
glutathione peroxidase and iodothyronine deiodinase
167
: essential amino acid coded by DNA (Maintains metabolic rate of selenium)
Selenocysteine
168
: can substitute for methionine as essential amino acid
Selenomethionine
169
Antioxidant properties
Selenium
170
Involved in metabolism of thyroid hormone
Selenium
171
Selenium Deficiency
Cardiomyopathy and skeletal muscle weakness
Osteoarthritis and increased incidence of cancer
172
Selenium Supplementation
Decreased risk of cancer (stomach, lung and prostate)
173
Selenium Laboratory determination :
AAS
