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Flashcards in Hematopoietic Growth Factors Deck (32)
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1

nutritional growth factors

ferrous iron (Fe2+)
folic acid
hydroxocobalamin (B12)

2

hormonal growth factors

Epoetin alpha; Darbepoetin
G-CSF
GM-CSF

3

what does erythropoiesis require

nutrients (iron, folic acid, vit B12) and
growth factors (G-CSF, GM-CSF, Epoetin)

4

what is iron needed to make

hemoglobin
each of the four heme groups has a central iron

5

source of iron

dietary- meat
(non-heme iron in foods like veggies must be reduced to ferrous iron for absorption)

6

form of body absorbable iron

ferrous iron (Fe2+)

7

what increases absorption of iron

vit C and HCL

8

what is the storage form of iron

ferritin

9

what is the transport form of iron

transferrin

10

how is iron eliminated

no excretion mechanisms
regulation of iron balance is achieved by changing absorption and storage of iron
when body iron stores are high: iron stored as ferritin
when body iron stores are low: iron transported to bone marrow for hemoglobin production

11

role of apoferritin

if free iron is low, synthesis is inhibited and iron binding shifts to transferrin
if free iron is high, synthesis stimulated and iron is sequestered as ferritin to protect organs from iron's toxic effects

12

treatment of acute iron toxicity

Deferoxamine

13

treatment of chronic iron toxicity AKA iron overload AKA hemochromatosis

phlebotomy or chelation therapy
chelators: Deferoxamine or Deferasirox

14

adverse affects of iron salts AKA oral iron supplements

epigastric distress
abdominal cramps
etc

15

what is used if patient can't tolerate/absorbe oral iron supplements

stable complex of ferric hydroxide and low molecular weight dextran given via muscular infection or IV infusion
other preps=sodium ferric gluconate, iron sucrose-less likely to produce anaphylaxis

16

iron balance is predominantly regulated by

absorption from diet

17

what does deficiency of vit B12 or folic acid lead to

megaloblastic anemia

18

vit B12 and folic acid deficiency has lots of the same effects but what additional thing does vit B12 deficiency lead to

neurologic syndorme because degeneration of myelin sheath

19

what is dietary folate dependent on

dietary use of folate is dependent on B12
so if B12 deficient there is a functional deficiency of dietary folate

20

where is vit B12 stored and how long are stores

liver
5 years to deplete

21

what population can you see vit B12 deficiency

strick vegetarians

22

what is vitamin B12 dependent on

intrinsic factor (pernicious anemia)

23

because supplemental folic acid enters the pathway at a different place than dietary folate, large amounts of folic acid can correct the anemia due to vit B12 but what can it not correct

cannot correct the neurologic damage

24

partial removal of which part of the GI tract could result in B12 deficiency

Illium
but also stomach due to intrinsic factor

25

how soon can anemia develop with deficiency of folic acid

1-6 months

26

what erythrocyte precursors are effected by EPO (Epoetin alpha) response

BFU-E
CFU-E
pro erythroblast
basophilic erythroblast

27

where is epoetin alpha made

kidneys (senses tissue hypoxia)

28

what does epoetin alpha do

induces release of reticulocytes from marrow

29

indications of epoetin alpha and anemia

anemia due to chronic renal failure
anemia due to AZT in HIV patients (HIV patients are being treated with AZT which dec EPO)

30

what is a better drug to use than epoetin alpha when patient has chronic renal failure

Darbepoetin alpha cuz clearance is slowed because longer half life