Iron Deficiency and Anaemia of Chronic Disease Flashcards Preview

Y2 MCD - Haematology - Laz > Iron Deficiency and Anaemia of Chronic Disease > Flashcards

Flashcards in Iron Deficiency and Anaemia of Chronic Disease Deck (37)
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1

In what state is the iron in the haem group of haemoglobin?

Fe2+ (ferrous)

2

How much iron do you need per day to maintain the production of red blood cells?

20 mg/day

3

How can iron be lost under normal, non-pathological conditions?

Desquamation of cells in the skin and gut
Bleeding (menstruation is one of the largest causes of loss of iron from the body in women)

4

How much iron does the human diet normally provide?

12-15 mg/day

5

State some natural foods that are high in iron.

Meat and fish
Vegetables
Whole grain cereal
Chocolate

6

Which form of iron cannot be absorbed?

Fe3+ (ferric)

7

What effect does drinking tea have on iron absorption?

Cups of tea promotes the conversion of Fe2+ to Fe3+

8

Why do meat and fish eaters have an advantage over vegetarians in terms of iron absorption?

They will absorb iron in the haem form

9

State three systemic factors that increase iron absorption.

Iron deficiency
Anaemia/hypoxia
Pregnancy

10

Which channel, on the basement membrane of intestinal epithelial cells, allows movement of iron into the circulation?

Ferroportin

11

What is a key regulator of iron absorption that affects ferroportin?

Hepcidin

12

How is the level of hepcidin affected?

There are certain proteins (such as hepcidin) that have iron-responsive elements in their genes
So iron is part of the complex that switches on hepcidin transcription

13

How is iron stored within cells?

In ferritin micelles

14

What transports iron in the circulation?

Transferrin

15

State three parameters that can be measured that involve transferrin?

Transferrin
Transferrin Saturation
Total Iron Binding Capacity (TIBC)

16

What is the normal transferrin saturation?

20-40%

17

Where is erythropoietin produced and what effect does it have?

Kidneys (stimulated by hypoxia)
Increase in red blood cell precursors
Red blood cell precursors will survive longer and the EPO will make them grow and differentiate to produce more progeny

18

What is anaemia of chronic disease?

Anaemia that is seen in patients with chronic disease

19

What typical signs of anaemia will these patients NOT have?

They will NOT be bleeding
They will NOT be iron deficient, B12 deficient or folate deficient
They will NOT have any bone marrow infiltration

20

State some laboratory signs of being ill.

Raised C-reactive protein (CRP)
Raised Erythrocyte Sedimentation Rate (ESR)
Raised Ferritin
Raised Factor VIII
Raised Fibrinogen
Raised Immunoglobulins

21

State some causes of anaemia of chronic disease.

Chronic infections – e.g. TB/HIV
Chronic inflammation – e.g. SLE, rheumatoid arthritis
Malignancy
Miscellaneous (e.g. cardiac failure)

22

What is the underlying cause of ACD?

ACD is due to the cytokine release that happens when someone is unwell
The cytokines block utilisation of iron by red blood cells
They also stop erythropoietin from increasing
Stop iron flowing out of cells Increase production of ferritin
Increased death of red cells

23

Give examples of cytokines involved in ACD.

TNF-
Interleukins

24

State four broad causes of iron deficiency.

Bleeding
Increased use (e.g. growth, pregnancy)
Dietary deficiency (e.g. vegetarian)
Malabsorption (e.g. Coeliac disease)

25

Under what conditions are full GI investigations performed?

Male
Women over 40
Post-menopausal women
Women with scanty menstrual loss

26

State some other investigations that can be performed.

Antibodies for coeliac disease
Check for urinary blood loss

27

State three causes of a low MCV.

Iron deficiency
Anaemia of chronic disease
Thalassemia trait

28

How would you confirm thalassemia trait?

Haemoglobin electrophoresis

29

How does serum iron help distinguish between the three causes of microcytic anaemia?

Iron deficiency – LOW serum iron
ACD – LOW serum iron

30

Describe the difference in ferritin levels in iron deficiency and anaemia of chronic disease.

Iron deficiency – LOW
ACD – HIGH (because it is an acute phase protein)