Hema 1 Disorders of Iron Kinetics and Heme Metabolism & Anemias Caused by defects of DNA Metabolism

What is the principle behind the Serum Iron (SI) test?

Measured colorimetrically after releasing iron from transferrin by acid, forming a colored complex that can be detected spectrophotometrically.

What are the three compartments of iron in the human body?

Functional, Storage, and Transport.

What is the role of Ferroportin in iron metabolism?

Ferroportin carries iron across the basolaminal enterocyte membrane into the bloodstream.

What condition arises from impaired iron mobilization and is common among hospitalized patients?

Anemia of Chronic Inflammation.

What laboratory test is considered the gold standard for assessing body iron?

Prussian Blue Staining.

What indicates Iron Deficiency Anemia (IDA) in terms of body iron supply?

Inadequate intake, increased need, impaired absorption, or chronic loss of hemoglobin.

What characterizes Stage 1 of Iron Deficiency Anemia?

Latent or subclinical iron deficiency with low serum ferritin and no symptoms.

What findings are typical for macrocytic anemia in peripheral blood?

Oval macrocytes and hypersegmented neutrophils.

What is the main etiology of megaloblastic anemia?

Impaired DNA synthesis.

How does Hepcidin affect iron absorption during inflammation?

It increases in production, decreasing iron absorption in the intestine and release from macrophages.

Which protein is responsible for transporting iron in the plasma?

Transferrin.

What is the significance of soluble transferrin receptor (sTfR) levels?

Indicator of functional iron available in cells.

What type of anemia is characterized by ring sideroblasts in the bone marrow?

Sideroblastic anemia.

What are common symptoms of Iron Deficiency Anemia?

Fatigue, weakness, shortness of breath, pallor, glossitis, angular cheilosis, koilonychia, and pica.

What is the impact of lead poisoning on porphyrin synthesis?

Lead interferes with the conversion of aminolevulinic acid to porphobilinogen and incorporation of iron into protoporphyrin.

What is the consequence of Vitamin B12 deficiency on DNA synthesis?

Inability to convert homocysteine to methionine, leading to accumulation and impaired cell replication.

What are the normal values for Serum Ferritin levels?

40-400 ng/mL.

What happens to ferritin levels during chronic inflammation?

Ferritin levels may be increased or normal despite decreased serum iron.

What substance is measured during the Deoxyuridine suppression test?

The ability of normal bone marrow to incorporate labeled thymidine into DNA.

What type of anemia is caused by Vitamin B12 deficiency resulting from autoimmune destruction of gastric parietal cells?

Pernicious anemia.

What is the primary function of iron in the human body?

Iron is essential for the formation of hemoglobin, which carries oxygen in the blood.

What are some dietary sources of iron?

Red meat, poultry, fish, lentils, beans, leafy greens, and fortified cereals.

What is the most common type of nutritional deficiency in the world?

Iron deficiency anemia.

What role does transferrin play in iron metabolism?

Transferrin binds and transports iron in the bloodstream.

How does the body regulate iron levels?

Through the production of hepcidin, which controls absorption and release of iron.

What is the difference between heme and non-heme iron?

Heme iron is found in animal products and is more easily absorbed, while non-heme iron is found in plant foods.

What is the function of ferritin in the body?

Ferritin stores iron for future use and releases it when needed.

What are the symptoms of iron overload in the body?

Fatigue, joint pain, abdominal pain, and liver damage.

Which population groups are at higher risk for iron deficiency?

Pregnant women, infants, young children, and those with heavy menstrual bleeding.

What is the relationship between ascorbic acid (vitamin C) and iron absorption?

Vitamin C enhances the absorption of non-heme iron.

What laboratory tests can help diagnose anemia?

Complete blood count (CBC), serum ferritin, and serum iron tests.

What is the role of erythropoietin in red blood cell production?

Erythropoietin stimulates the production of red blood cells in the bone marrow.

How does chronic disease affect iron levels in the body?

Chronic disease can lead to anemia of chronic inflammation, where iron stores are present but not available for use.

What are sideroblasts?

Sideroblasts are erythroblasts with iron granules that indicate impaired hemoglobin synthesis.

What is the effect of iron deficiency on cognitive function?

Iron deficiency can impair cognitive development and function, particularly in children.

What are pica and its association with iron deficiency?

Pica is the craving and consumption of non-nutritive substances, which can be related to iron deficiency.

What is the common treatment for iron deficiency anemia?

Iron supplementation and dietary changes to increase iron intake.

What role does the liver play in iron metabolism?

The liver stores iron and produces hepcidin to regulate iron levels.

What is the significance of hemoglobin electrophoresis?

It is used to identify different types of hemoglobin and diagnose disorders like sickle cell disease.

What test is used to determine iron-binding capacity in serum?

Total iron-binding capacity (TIBC) measures how well iron is transported in the blood.

How can inflammatory conditions affect ferritin levels?

Inflammation can increase ferritin levels even if actual iron stores are low, masking iron deficiency.

What is the significance of the reticulocyte count in anemia?

A high reticulocyte count indicates the marrow is responding to anemia, while a low count indicates inadequate response.

What symptoms characterize megaloblastic anemia?

Fatigue, weakness, pallor, and neurological symptoms due to vitamin B12 or folate deficiency.

What is the main cause of pernicious anemia?

Autoimmune destruction of gastric parietal cells leading to vitamin B12 deficiency.

What is the purpose of a bone marrow biopsy in diagnosing anemia?

To assess the bone marrow's ability to produce blood cells.

What are the typical blood findings in chronic disease-related anemia?

Normocytic red blood cells, normal ferritin, and decreased iron levels.

What dietary habits can improve absorption of non-heme iron?

Consuming vitamin C-rich foods, avoiding calcium-rich foods at the same time, and cooking in iron cookware.

What common over-the-counter medications can interfere with iron absorption?

Antacids and proton pump inhibitors can reduce iron absorption.

What is the recommended daily iron intake for adult males and females?

Adult males need about 8 mg/day, while adult females need about 18 mg/day due to menstruation.

How does heavy menstrual bleeding contribute to iron deficiency?

It can lead to increased blood loss, which reduces iron levels in the body.

The recommended daily iron intake for adults is __________ mg for males and __________ mg for females.

8; 18.