MMSC 433 exam 1 with accurate detailed solutions ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
iron absorption - correct answer✔✔-ferric iron is taken in from diet
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferric iron is reduced by duodenal cytochrome B to become ferrous iron
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferrous iron is absorbed into enterocytes by DMT 1
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-absorbed iron is stored as ferritin, or sent into portal hepatic circulation and carried by
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
transferrin to developing RBCs ||//\\|| ||//\\|| ||//\\||
transferrin - correct answer✔✔plasma carrier protein for ferrous iron ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
high iron level regulation - correct answer✔✔-hepcidin is released from hepatocytes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferroportin is inactivated, leading to decreased iron being transported into circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
low iron level regulation - correct answer✔✔-hepcidin is down regulated by hepatocytes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferroportin becomes activated and transports iron out of the enterocytes and into circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
dietary iron sources - correct answer✔✔red meat, legumes, dark leafy vegetables, whole
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
grains
ferrous iron - correct answer✔✔the form of iron that is able to be utilized in the body for
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
developing red cells ||//\\|| ||//\\||
prussian blue stain - correct answer✔✔stain that is used to identify iron in tissues and bone
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
marrow
,thomas plot - correct answer✔✔a chart that is used to compare soluble transferrin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
receptors/ log ferritin to hemoglobin concentration of reticulocytes to identify the iron status ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of the patient
||//\\|| ||//\\|| ||//\\|| ||//\\||
-iron status is used to correlate to certain diseases/ anemias
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
stage 1 iron deficiency (progressive loss of storage iron) - correct answer✔✔-asymptomatic
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-RBCs develop normally ||//\\|| ||//\\||
-*serum ferritin low* ||//\\|| ||//\\||
stage 2 iron deficiency (exhaustion of iron storage pool) - correct answer✔✔-subclinical
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
symptoms
-hemoglobin in retics is decreased, *hemogram appears normal still* ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-iron deficiency erythropoiesis is occurring
||//\\|| ||//\\|| ||//\\|| ||//\\||
-hepcidin decreased ||//\\||
-serum iron and ferritin decreased ||//\\|| ||//\\|| ||//\\|| ||//\\||
-RDW, TIBC and sTRs increased ||//\\|| ||//\\|| ||//\\|| ||//\\||
-prussian blue stain of BM is negative for iron ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
stage 3 iron deficiency (frank anemia) - correct answer✔✔-patient exhibits fatigue, weakness,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
pallor, glossitis, koilonychia and pica
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-*H/H decreased* ||//\\||
-*hypochromic/ microcytic anemia* ||//\\|| ||//\\||
-FEP, TIBC and sTR increased
||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferritin, hepcidin and serum iron decreased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
sideroblastic anemia - correct answer✔✔-iron deposits in the mitochondria of erythroblast ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cells in the bone marrow interfere with biosynthesis of heme
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, -caused by genetic inheritance of drugs/ bone marrow toxins (*lead*, antibiotics,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
chemotherapeutics)
-*ringed sideroblasts* are highly indicative of the disease ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-basophillic stippling is common in lead poisoning ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-normocytic normochromic cells ||//\\|| ||//\\||
iron deficiency anemia (IDA) - correct answer✔✔-caused by inadequate intake, increased
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
need or malabsorption of iron, poor diet or chronic blood loss
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-symptoms: fatigue, weakness, pallor, spooning of the nails (koilonychia) and pica ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-*H/H decreased* ||//\\||
-microcytic, hypochromic cells ||//\\|| ||//\\||
-marked poikilocytosis (target cells, spherocytes, tear drop cells and schistocytes)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-FEP, sTR and TIBC increased
||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferritin, hepcidin and serum iron decreased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anemia of chronic inflammation - correct answer✔✔-anemia occurring secondary to
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
underlying condition (chronic inflammatory disease, chronic infection or malignancy) that ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
causes release of cell products ||//\\|| ||//\\|| ||//\\|| ||//\\||
-hepcidin, lactoferrin and inflammatory cytokines cause decreased iron status and anemia
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-low Hgb||//\\||
-*low TIBC* (hepcidin is increased due to acute phase reaction)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-normocytic normochromic anemia ||//\\|| ||//\\||
-serum iron decreased ||//\\|| ||//\\||
-ferritin (acute phase reactant) and FEP increased||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hereditary hemochromatosis (HH) - correct answer✔✔-inheritance of mutated HFE gene ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
inhibits production of hepcidin, leading to constant activation of ferroportin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
iron absorption - correct answer✔✔-ferric iron is taken in from diet
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferric iron is reduced by duodenal cytochrome B to become ferrous iron
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferrous iron is absorbed into enterocytes by DMT 1
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-absorbed iron is stored as ferritin, or sent into portal hepatic circulation and carried by
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
transferrin to developing RBCs ||//\\|| ||//\\|| ||//\\||
transferrin - correct answer✔✔plasma carrier protein for ferrous iron ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
high iron level regulation - correct answer✔✔-hepcidin is released from hepatocytes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferroportin is inactivated, leading to decreased iron being transported into circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
low iron level regulation - correct answer✔✔-hepcidin is down regulated by hepatocytes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferroportin becomes activated and transports iron out of the enterocytes and into circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
dietary iron sources - correct answer✔✔red meat, legumes, dark leafy vegetables, whole
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
grains
ferrous iron - correct answer✔✔the form of iron that is able to be utilized in the body for
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
developing red cells ||//\\|| ||//\\||
prussian blue stain - correct answer✔✔stain that is used to identify iron in tissues and bone
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
marrow
,thomas plot - correct answer✔✔a chart that is used to compare soluble transferrin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
receptors/ log ferritin to hemoglobin concentration of reticulocytes to identify the iron status ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of the patient
||//\\|| ||//\\|| ||//\\|| ||//\\||
-iron status is used to correlate to certain diseases/ anemias
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
stage 1 iron deficiency (progressive loss of storage iron) - correct answer✔✔-asymptomatic
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-RBCs develop normally ||//\\|| ||//\\||
-*serum ferritin low* ||//\\|| ||//\\||
stage 2 iron deficiency (exhaustion of iron storage pool) - correct answer✔✔-subclinical
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
symptoms
-hemoglobin in retics is decreased, *hemogram appears normal still* ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-iron deficiency erythropoiesis is occurring
||//\\|| ||//\\|| ||//\\|| ||//\\||
-hepcidin decreased ||//\\||
-serum iron and ferritin decreased ||//\\|| ||//\\|| ||//\\|| ||//\\||
-RDW, TIBC and sTRs increased ||//\\|| ||//\\|| ||//\\|| ||//\\||
-prussian blue stain of BM is negative for iron ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
stage 3 iron deficiency (frank anemia) - correct answer✔✔-patient exhibits fatigue, weakness,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
pallor, glossitis, koilonychia and pica
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-*H/H decreased* ||//\\||
-*hypochromic/ microcytic anemia* ||//\\|| ||//\\||
-FEP, TIBC and sTR increased
||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferritin, hepcidin and serum iron decreased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
sideroblastic anemia - correct answer✔✔-iron deposits in the mitochondria of erythroblast ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cells in the bone marrow interfere with biosynthesis of heme
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, -caused by genetic inheritance of drugs/ bone marrow toxins (*lead*, antibiotics,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
chemotherapeutics)
-*ringed sideroblasts* are highly indicative of the disease ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-basophillic stippling is common in lead poisoning ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-normocytic normochromic cells ||//\\|| ||//\\||
iron deficiency anemia (IDA) - correct answer✔✔-caused by inadequate intake, increased
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
need or malabsorption of iron, poor diet or chronic blood loss
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-symptoms: fatigue, weakness, pallor, spooning of the nails (koilonychia) and pica ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-*H/H decreased* ||//\\||
-microcytic, hypochromic cells ||//\\|| ||//\\||
-marked poikilocytosis (target cells, spherocytes, tear drop cells and schistocytes)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-FEP, sTR and TIBC increased
||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferritin, hepcidin and serum iron decreased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anemia of chronic inflammation - correct answer✔✔-anemia occurring secondary to
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
underlying condition (chronic inflammatory disease, chronic infection or malignancy) that ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
causes release of cell products ||//\\|| ||//\\|| ||//\\|| ||//\\||
-hepcidin, lactoferrin and inflammatory cytokines cause decreased iron status and anemia
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-low Hgb||//\\||
-*low TIBC* (hepcidin is increased due to acute phase reaction)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-normocytic normochromic anemia ||//\\|| ||//\\||
-serum iron decreased ||//\\|| ||//\\||
-ferritin (acute phase reactant) and FEP increased||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hereditary hemochromatosis (HH) - correct answer✔✔-inheritance of mutated HFE gene ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
inhibits production of hepcidin, leading to constant activation of ferroportin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
