Ch. 10 Iron Def. Anemias

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Ch. 10 Iron Def. Anemias
2013-02-10 20:33:55

Iron Deficiency Anemia and Anemia of Chronic Inflammation
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  1. Iron Deficiency Anemia
    Is the most common anemias worldwide
  2. Causes of Iron Deficiency Anemia:
    • Nutritional deficiency
    • GI disease
    • Increased demand for erythropoiesis
    • Excess iron loss (excessive bleeding)
  3. Types of iron anemias:
    • Sideroblastic anemias
    • Chronic inflammation
    • Decreased plasma transferrin
  4. When does the demand for iron increase?
    • Pregnancy
    • Menustration
    • Growth
  5. How many grams of iron per person?
    • 3-5
    • Conservation of iron is normally very efficient
  6. Iron need in infants and children:
    • Full term infants have 4 months iron storage.
    • 50% iron absorption from human milk
  7. Milk anemia
    Occur in infants that depend solely on cow's milk.
  8. Diet Iron:
    • 90% of dietary iron is non-heme
    • 10% heme iron is well absorbed.
  9. Factors that increase non-heme iron absorption:
    Meats, ascorbic acid (OJ)
  10. Factors that decrease non-heme iron absorption
    Vegetable fibers and tea
  11. Ingested ferric iron (Fe3+) is reduced to __________ iron by stomach acid.
    ferrous (Fe2+)
  12. Where is most iron absorbed?
    Upper jejunum
  13. __________ delivers iron to bone marrow.
  14. Papillodema:
    Dents in forehead of infants
  15. PICA syndrome:
    Eat dirt, weird things
  16. Labs of iron deficiency anemia:
    • Decreased RBC, HGB, HCT, MCH,MCHC, MCV
    • Hypochromic-Microcytic RBCs
    • WBC=normal
    • Platelets=Normal to increased
    • Total serum iron=decreased
    • TIBC=Increased
    • %Fe saturation=Decreased
    • Plasma ferritin= Decreased

    Decreased plasma ferritin is the best single test, and earliest, indication of iron deficiency.
  17. Iron deficiency anemia
    • Severe iron anemia
    • Teardrops and elliptocytes (common in Fe deficiency)
  18. Anemias of Inflammation or Chronic Disorders:
    • Associated with chronic inflammatory conditions (RA, SLE, Cancers,Liver and renal diseases)
    • Not an iron deficiency.
  19. Labs of (ACD)
    • Mild anemia.
    • Normal to hypo-micro RBC morphology
    • Decreased=plasma iron and TIBC
    • Increased=plasma ferritin
  20. Sideroblastic Anemias
    • Ineffective erythropoiesis with excess iron accumulation in the mitochrondia or bone marrow precurssors.
    • Iron is "trapped" in cytoplasma
  21. Sideroblastic anemia causes:
    • Genetic
    • Leukemias
    • Drug/Toxins
    • Myelodysplastic syndromes
  22. Sideroblastic anemia labs:
    • 10-40% ringed sideroblasts in the bone marrow.
    • Hypochromic-microcytic RBCs
    • Basophilic stippling, target cells, dimorphic RBCs.

    INCREASED=Plasma iron, TIBC, Ferritin
  23. (HH) Hereditary Hemochromatosis:
    • Genetic (autosomal recessive) disorder of excessive GI iron absorption.
    • Excess iron accumulations in the tissues can cause damage.
    • Common in Celtic ancestry.
    • 1 in 10 persons are estimated to carry the gene.

    INCREASED=Plasma ferritin, transferrin saturation

    Treated by therapeutic phlebotomy (removes iron)
  24. Top 10
    • Iron deficiency is common.
    • Iron conservation prevents loss of iron.
    • Hypo-Micro anemia
    • Transferrin: Iron transport plasma protein
    • Ferritin: Iron storage molecule
    • Sideroblastic anemias: Iron trapped in marrow NRBCs
    • Hemochromatosis: excess iron
    • Anemias of inflammation: Iron not released from RE system