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Why is free iron in the blood dangerous
It creates free radicals
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What is the role of Ferritin
It is a storage place for iron in the cell, it also protects the cell from iron's potentially harmful effects
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What is the role of Transferrin
It transports iron groups to their destination, carries two at a time
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What is the difference between Ferrous iron and Ferric iron
- Ferrous iron is in the reduced form Fe +2 (II)
- Ferric iron is in the oxidized form Fe +3 (III)
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What is the nutritional requirement of iron per day
1-3 mg per day
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What is the primary way to lose iron
- Stool
- For women menstrual loss
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When there is a reduced amount of myoglobin and hemoglobin function in the body, how does it respond
Erythropoeitin is triggered to rev up, which requires Fe II and Heme
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Cytochrome P450 has what function that requires the use of iron
It detoxifies drugs and other oxidative reactions in the ER
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Cytochromes a, b, and c use iron in what important function
ATP production in the mitochondria specifically with the electron transport chain
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What do iron response elements do (IRE)
- They sense iron content in cells and adjust the amount of cellular uptake accordingly.
- They are found as nucleotides in transferrin and ferritin related mRNA transcripts
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What is the protein that controls the movement of iron out of the cell
Ferroportin
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What is the main site for uptake of iron
Duodenum
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What important elements facilitate the uptake of iron into the Duodenum
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What can inhibit the uptake of iron
- Phytates
- Phosphates
- Tannins
- Antacids
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Hepcidin has what effect on iron
It is considered the master iron inhibitor and restricts the availability of iron in cancer and inflammation by controlling ferroportin activity
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ROS (Reactive oxygen species) promote
Aging and disease
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Iron can be an effective marker for homeostasis of what organ
- Bone marrow
- This is because the amount of Ferritin that leaks out of the bone marrow is directly proportional to the iron content
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Patient on dialysis need to have iron monitored daily as to ensure
That the iron is being adequately cleared avoiding iron toxicity
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What is inherited hemochromatosis
It is an inherited iron overload that up regulates the movement of iron into the enterocytes
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What are the ages that hemochromatosis is most likely found
40-60 years old
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What are some iron overload disorders
- Thalassemias (Reduced hemoglobin synthesis)
- Sideroblastic Anemia (RBC synthesis issues)
- Chronic liver disease
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What does an overload of iron cause
- Arthropathy (Joint issues)
- Hepatomegaly
- Splenomegaly
- Liver Cirrhosis
- Hypogonadism
- Diabetes
- Skin Hyperpigmentation
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What are some treatments for iron overload
- Phlebotomy 1-2 times a week
- Avoidance of iron intake
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B12 and Folate (Folic Acid) are important to what biological functions
- DNA synthesis reactions
- Essential Coenzymes
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What is Megaloblastic anemia caused by
Inhibition of DNA synthesis in RBC's
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Cobalamine is an important structural component of
B12 and is important to nucleotide synthesis, as well as the control of fatty acid synthesis in myelin sheaths
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The absorption of B12 in the illeum requires what
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Folate is absorbed by
Brush border enterocytes
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What is Folate absorption inhibited by
- Phenytoin
- Alcohol
- Oral Contraceptives
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What will a lack of B12 display that a lack of Folate won't
Wobbling Gait
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In addition to B12 and Folate, what else relating to iron is necessary for erythropoeisis
Heme biosynthesis
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Lead inhibits what important reaction to make heme
Ferrochelatase (converts protoporphyrin IX into heme by adding the iron element)
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Heme is synthesized by what cells
Reticulocytes
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Heme is broken down to what substance by the spleen
Bilirubin
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What does the interruption to bilirubin clearance cause
Jaundice
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Neonatal jaundice can be attributed most of the time to
Undeveloped liver
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While in the blood, what is bilirubin linked to
Albumin, upon transfer to the liver they disassociate
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The eventual elimination of heme is through the
Bile
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Severe excess of bilirubin in the blood will accumulate in what tissues leading to Kernicterus
In the nervous tissue, this is very dangerous for infants (passes the BBB)
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Ribose is crucial for making substances for the cell to
Divide
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A deficiency in G6PD can have what effect on Ribose development
It will inhibit it, leading to an anemic crisis
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NADPH has what effect on G6PD
High amounts inhibits it, because it is its product
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Vegetarians are notorious for having low
B12
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Pernicious anemia can be due to a lack of
Intrinsic factor (inability to absorb B12)
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If megaloblasts are present in a patient with hematocrit issues what can be eliminated as a cause
Iron deficiency
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Heinz bodies and denatured hemoglobin suggests what what deficiency
G6PDH
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Absence of NADPH formation is a positive test for
Glucose 6 Phosphate dehydrogenase deficiency
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Erythrocyte Oxidant control is via
Glutathione reductase
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Steroid and and fatty acid synthesis in the liver is done by
Fatty acid synthase and HMG-CoA reductase
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Aconitase is
An iron response element (IRE)
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What physical property of bilirubin results in jaundice when bilirubin is found in high amounts
Its fat solubility and hydrophobicity
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Homocysteine is converted to cysteine via
B vitamins
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The only two recognizable cobalamine dependent enzymes in human cells are
- Methylmalonyl CoA mutase
- Methyltetrahydrofolate- homocysteine methyl transferase (methionine synthase)
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Methyltetrahydrofolate- homocysteine methyl transferase (methionine synthase) deficiency leads to
Megaloblastic anemia
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Prophyrias is
Impaired biosynthesis of Heme
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