CH. 17 - Disorders of Iron Kinetics and Heme Metabolism

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Iron deficiency

This results from inadequate iron intake, increased need, decreased absorption, or excessive loss

Sideroblastic anemia

Type of anemia that develops when the synthesis of protoporphyrin or the incorporation of iron into protoporphyrin is blocked

Iron-loading anemia

Type of anemia with erythroid hyperplasia that increases levels of erythroferrone leading to decreased hepcidin, increased ferroportin activity, and increased iron absorption

Free iron

This becomes available in cells when ferritin and hemosiderin become saturated

Chronic gastrointestinal bleeding

GUIDE QUESTION:

In men and postmenopausal women whose diets are adequate, iron deficiency anemia most often results from?

A 15-year-old boy who eats mainly junk food

GUIDE QUESTION:

Which one of the following individuals is at greatest risk for the development of iron deficiency anemia?

A 65-year-old man with hypertension

GUIDE QUESTION:

Which of the following individuals is at the greatest risk for the development of anemia of chronic inflammation?

Any condition that prevents iron incorporation into protoporphyrin IX

GUIDE QUESTION:

In what situation will increased levels of free erythrocyte protoporphyrin be present?

Increase during inflammation and reduce iron absorption from enterocytes

GUIDE QUESTION:

In the pathogenesis of the anemia of chronic inflammation, hepcidin levels:

Failure to incorporate iron into protoporphyrin IX

GUIDE QUESTION:

Sideroblastic anemias result from:

The hepcidin-ferroportin iron regulatory system

GUIDE QUESTION:

In general, most instances of hereditary hemochromatoses result from mutations that impair:

Heightened propensity for sunburns

GUIDE QUESTION:

In the erythropoietic porphyrias, mild anemia may be accompanied by what distinctive clinical finding?

Iron restricted

When iron is the limiting factor, the anemias are called?

Functional iron deficiency

Type of deficiency in which iron stores are adequate but the iron is not available to support normal erythropoiesis

Stage 1

What stage of iron deficiency is characterized by a progressive loss of storage iron

Stage 2

What stage of iron deficiency is defined by the exhaustion of the storage pool of iron?

Stage 3

What stage of iron deficiency is frank anemia?

The hemoglobin concentration and hematocrit are low relative to the reference intervals.

Elevated RDW

This can be an early and sensitive indicator of iron deficiency that is provided in a routine CBC

TIBC

It is an indirect measure of transferrin and the available binding sites for iron

Ferritin

It provides an intracellular storage repository for metabolically active iron

Sideropenia

Serum ferritin and serum iron values are decreased in iron deficiency anemia, a state called?

Anemia of chronic inflammation

Anemia of chronic disease is more correctly termed:

Hepcidin

A hormone produced by hepatocytes to regulate body iron levels, particularly absorption of iron in the intestine and release of iron from macrophages and hepatocytes

Provides protection for the phagocyte from oxidized iron that forms when reactive oxygen species (ROS) are produced during phagocytosis

Ring sideroblasts

These are the hallmark of the sideroblastic anemias

Porphyria

It refers to the hereditary conditions that impair production of protoporphyrin

Hereditary hemochromatoses

Failure of normal regulation as a result of mutations leads to excessive absorption and storage, causing the diseases collectively known as the?

Bronzed diabetes

Hemochromatosis has been characterized as?

Children

They are especially vulnerable to the effects of lead on the central nervous system

Elevated transferrin saturation

It can be an indicator of hemochromatosis that can be diagnosed fully using genetic testing to identify mutated genes.