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What is anemia primarily defined as?
What is anemia primarily defined as?
Haemoglobin is a protein responsible for transporting oxygen and carbon dioxide within the body.
Haemoglobin is a protein responsible for transporting oxygen and carbon dioxide within the body.
True (A)
What are the two main components that are considered to be lower than normal in the definition of anemia?
What are the two main components that are considered to be lower than normal in the definition of anemia?
The number of red blood cells (RBCs) and the haemoglobin concentration within RBCs.
Anemia is a ______ public health problem that can lead to increased risk of ______ and ______ especially in pregnant women and young children.
Anemia is a ______ public health problem that can lead to increased risk of ______ and ______ especially in pregnant women and young children.
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Hematocrit refers to the percentage of red blood cells (RBCs) in the total volume of blood.
Hematocrit refers to the percentage of red blood cells (RBCs) in the total volume of blood.
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Which stage of iron depletion involves decreased serum ferritin levels but no physiological effects?
Which stage of iron depletion involves decreased serum ferritin levels but no physiological effects?
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Anemia characterized by smaller than normal red blood cells is classified as ______.
Anemia characterized by smaller than normal red blood cells is classified as ______.
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What is a common consequence of iron deficiency anemia?
What is a common consequence of iron deficiency anemia?
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Match the following types of anemia with their corresponding RBC size:
Match the following types of anemia with their corresponding RBC size:
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Anemia is a condition where the number of red blood cells (RBCs) or hemoglobin concentration is below normal.
Anemia is a condition where the number of red blood cells (RBCs) or hemoglobin concentration is below normal.
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Hemoglobin, a protein found in red blood cells, is responsible for transporting ______ to body tissues and ______ back to the lungs.
Hemoglobin, a protein found in red blood cells, is responsible for transporting ______ to body tissues and ______ back to the lungs.
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What are the two main components considered lower than normal in the definition of anemia?
What are the two main components considered lower than normal in the definition of anemia?
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What is the primary function of hemoglobin in the body?
What is the primary function of hemoglobin in the body?
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Match the following terms with their definitions:
Match the following terms with their definitions:
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Which of the following is NOT a primary location for iron storage in the human body?
Which of the following is NOT a primary location for iron storage in the human body?
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Each heme group in a hemoglobin molecule can bind two oxygen atoms.
Each heme group in a hemoglobin molecule can bind two oxygen atoms.
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What is the primary storage form of iron in the human body?
What is the primary storage form of iron in the human body?
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The protein responsible for carrying iron in the blood is called ______.
The protein responsible for carrying iron in the blood is called ______.
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Match the following iron-related terms with their descriptions:
Match the following iron-related terms with their descriptions:
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What is the most sensitive indicator of iron deficiency in the early stages?
What is the most sensitive indicator of iron deficiency in the early stages?
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An isolated hemoglobin measurement is a reliable indicator of iron status.
An isolated hemoglobin measurement is a reliable indicator of iron status.
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What is the cut-off value for hemoglobin (Hb) in g/L for a pregnant woman considered anemic?
What is the cut-off value for hemoglobin (Hb) in g/L for a pregnant woman considered anemic?
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Study Notes
Anemia Overview
- Anemia is a condition where the number of red blood cells (RBCs) or the hemoglobin concentration within RBCs is lower than normal.
- It's a widespread public health problem, increasing morbidity and mortality, especially in pregnant women and young children.
- Hemoglobin (Hb) is a protein that binds oxygen in the lungs, transporting it to body tissues and binding CO2 from tissues, sending it back to the lungs for exhalation.
- Each hemoglobin molecule contains four polypeptide chains (globin) and four heme groups with an iron (ferrous, Fe+2) center.
- Each heme group can bind one oxygen atom.
- Hemoglobin is a crucial index of the blood's oxygen-carrying capacity.
- While hemoglobin measurements are used as a screening tool for iron deficiency anemia, they're not sufficient alone to determine iron status.
Iron Storage
- Iron is an essential element stored in the body as ferritin and hemosiderin.
- These are iron-containing proteins primarily found in the liver, spleen, bone marrow, and other anatomical areas, such as duodenum, skeletal muscle.
- Ferritin is the primary storage form of iron.
Assessing Anemia
- Hemoglobin measurement is crucial for anemia assessment.
- Different cut-off values for hemoglobin are used to determine anemia based on age and sex.
- These levels are crucial to differentiating various types of anemia.
Indicators of Iron Status
- Hemoglobin isn't the most sensitive indicator in early stages of anemia development.
- Ferritin levels are a more sensitive marker of iron stores, decreasing early in iron deficiency.
- Serum ferritin levels can be affected by infection and inflammation, sometimes increasing.
- A ferritin value below 10 mg/dL usually indicates iron deficiency.
- Other indicators, like the soluble transferrin receptor (sTfR), can also help gauge iron status.
Other Iron Status Markers
- Transferrin is a protein that transports iron and increases in response to iron deficiency conditions, such as infection.
- Hematocrit is the percentage of RBCs in the whole blood volume and correlates with hemoglobin while influenced by RBC volume.
Iron Deficiency
- Iron depletion can be categorized into three stages:
- Stage 1: Iron stores are depleted without noticeable physiological effects, but serum ferritin levels decrease.
- Stage 2: Iron deficiency without anemia (early or mild), with potential adverse physiological consequences.
- Stage 3: Iron-deficiency anemia, marked by decreased serum ferritin along with other indicators.
Types of Anemia
- Anemia is often categorized as macrocytic or microcytic based on the volume of red blood cells (RBCs).
- Microcytic anemia involves abnormally small RBCs.
- Macrocytic anemia involves abnormally large RBCs.
Iron Deficiency Anemia (IDA)
- Iron deficiency is a common micronutrient and nutritional deficiency, affecting over 30% of the global population, equivalent to roughly 1 billion individuals.
- IDA is a significant issue, contributing to about 800,000 estimated worldwide deaths.
- In many developing regions, almost half of pregnant women and more than a third of preschool children are estimated to have iron deficiency.
Consequences of Iron Deficiency Anemia
- Mild IDA may have few consequences due to the body's compensatory mechanisms for oxygen extraction.
- Moderate and severe IDA are associated with increased maternal and child mortality, infectious diseases, heart failure, and poor wound healing.
- Pregnancy-related IDA can lead to premature birth and low birth weight, potentially increasing infant mortality risks
- In general, IDA reduces muscle performance.
Categories at Risk of Iron Deficiency
- Infants and early childhood: poor iron status substantially impacts cognitive, motor, and social development during rapid growth phases.
- Breast milk is low in iron after 6 months. Iron needs increase during this time.
- Early introduction of cow's milk to infant diets (before 12 months) presents a risk factor.
- School-aged children may experience reduced performance and learning ability due to iron deficiency.
- Pregnant women face increased iron needs and potential blood loss during delivery.
- Women of child-bearing age experience significant iron losses via menstruation.
Micronutrients and Anemia
- Other micronutrients, including Zinc, Copper, Vitamin B9, Vitamin B12, and Vitamin A are also vital for iron function and red blood cell production.
- Deficiencies in these nutrients can increase the risk of anemia indirectly
Copper in Relation to Anemia
- Copper is an essential nutrient for protein function and oxidation-reduction in the body.
- Copper deficiency contributes to anemia because proteins that use copper are critical for iron utilization.
Zinc in Relation to Anemia
- Zinc's role in RBC growth and its presence in similar foods to iron places it among the risk factors for anemia.
- Zinc inhibits iron and copper absorption.
B-Vitamins and Anemia
- B-vitamins like folate and B12 are critical for DNA synthesis, impacting cell division (such as red blood cell production) and causing larger RBCs.
- B12 deficiency might cause pernicious anemia if intrinsic factor is lacking (for B12 absorption).
- Riboflavin (B2), though common in diets, will lead to normocytic normochromic anemia in severe or prolonged deficiency.
- Pyridoxal (B6) may also be a factor.
Vitamin A and Iron Deficiency Anemia
- Vitamin A deficiency may impact iron absorption, storage, and transport leading to iron-deficient erythropoiesis.
- Sources include liver, cod liver oil, milk, cheese and fortified foods.
Dietary Iron
- Iron in food exists in two forms: heme (more readily absorbed, found in animal products) and non-heme (less readily absorbed, found in plant foods).
- Absorption of non-heme iron can be increased by ascorbic acid (Vitamin C) or reduced by factors like phytates or calcium
Dietary Treatment of Iron Deficiency Anemia
- Iron is needed to replace losses in the body, including those from menstruation.
- Dietary requirements vary based on age, physiological status and maturity.
- Iron is found in animal foods (heme iron). Non-heme iron is found in plant foods.
Iron Absorption
- Substances that keep iron absorbed in its ferrous form (such as ascorbic and citric acids in fruits), are crucial for iron absorption.
- Factors that hinder iron absorption (such as phytates, calcium or oxalate) should be avoided.
Foods Rich in Iron
- Foods such as liver, lean red meat, poultry, tuna, salmon, iron-fortified cereals; egg yolks, beans, nuts, dried fruit and dark leafy greens are rich in iron.
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Description
Explore the critical aspects of anemia, including its impact on health, particularly in vulnerable populations like pregnant women and children. Understand the role of hemoglobin in oxygen transport and the significance of iron storage in the body. Test your knowledge on these essential topics in hematology.
