Anemias and Hemoglobin Reference Intervals

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Questions and Answers

Where is the majority of storage iron found?

Red blood cells

Macrophages of the reticuloendothelial system (correct)

Gastrointestinal tract

Plasma pool

What is the main form of iron transport in the plasma?

Ferritin

Hemosiderin

Hemoglobin

Transferrin (correct)

What is the primary route of iron loss from the body?

Loss of cells (correct)

Urine

Feces

Sweat

What is the difference between absolute and relative anemia?

Absolute anemia is characterized by a decrease in red blood cell mass, while relative anemia is characterized by an increase in plasma volume. Signup and view all the answers

Which of the following is NOT a cause of absolute anemia?

Increased plasma volume Signup and view all the answers

What is the significance of the statement 'Very little iron is lost from the body'?

It implies that iron recycling is highly efficient. Signup and view all the answers

What is the normal range for Serum Ferritin levels?

12 to 300 μg/L Signup and view all the answers

What is indicative of inadequate folate intake?

Folic acid deficiency Signup and view all the answers

What form of iron is given orally for supplementation?

Ferrous iron Signup and view all the answers

How often should Ferrous iron be taken for optimal absorption?

Between meals Signup and view all the answers

What does Serum Ferritin reflect in healthy subjects?

Storage iron Signup and view all the answers

What is a potential issue with tissue cells in iron metabolism?

Equilibrium with ferritin levels Signup and view all the answers

What is a common dosage of Ferrous iron for supplementation?

200 mg in three doses Signup and view all the answers

What could indicate a disorder in iron metabolism?

High levels of ferritin Signup and view all the answers

What characterizes absolute polycythemia?

An increase in the total red cell mass Signup and view all the answers

What defines the inherited pattern of a defective gene causing certain conditions?

Autosomal recessive pattern Signup and view all the answers

Which factor is NOT listed as a risk for developing symptoms in porphyria cutanea tarda?

Exposure to sunlight Signup and view all the answers

What can trigger an increase in the body's demand for heme production?

Smoking or excessive alcohol use Signup and view all the answers

For women, what is the threshold level of hemoglobin that could indicate a condition related to polycythemia?

More than 16.5 g/dL Signup and view all the answers

What is a common characteristic of porphyria cutanea tarda?

It is usually acquired rather than inherited Signup and view all the answers

What defines anemia in relation to hemoglobin concentration?

Hb concentration or hematocrit below the lower limit of the reference interval Signup and view all the answers

What happens to the iron from circling red blood cells during degradation?

It enters the plasma and binds to transferrin Signup and view all the answers

How often does approximately 1% of total circulating red cells get destroyed?

Several times a day Signup and view all the answers

Which of the following individuals would NOT typically be considered anemic?

An individual with Hb within the reference intervals for their age Signup and view all the answers

Where does erythron iron primarily enter the plasma from?

From hemoglobin degradation in macrophages Signup and view all the answers

What role does transferrin play in the body regarding iron?

It binds iron for transportation in the plasma Signup and view all the answers

In the context of erythrocytic disorders, what does the term 'normoblasts' refer to?

Immature red blood cell precursors in the marrow Signup and view all the answers

Why is it significant to consider the individual's own usual values of Hb?

To determine if their current Hb is significantly different from their baseline Signup and view all the answers

What is the main characteristic of megaloblastic anemia?

Presence of many large red blood cells. Signup and view all the answers

Which of the following is NOT a cause of macrocytic anemia that is not megaloblastic?

Iron deficiency. Signup and view all the answers

What is the term used to describe the early release of erythrocytes from the marrow?

Reticulocytosis. Signup and view all the answers

Which of the following conditions can be associated with marked red cell fragmentation in some cases of folate acid deficiency?

Microangiopathic hemolytic anemia. Signup and view all the answers

Which of the following is a possible reason for slow or partial response to parental iron in patients?

The patient has a deficiency in folic acid. Signup and view all the answers

What is the main difference between megaloblastic anemia and macrocytic anemia that is not megaloblastic?

The presence of megaloblasts in the bone marrow. Signup and view all the answers

Study Notes

Anemias

Anemia is indicated by a hemoglobin (Hb) concentration or hematocrit (Hct) below the 95% reference interval for an individual's age, sex, and geographic location.
A person with Hb within the reference range but significantly lower than their usual values is considered anemic.
Distinction between absolute anemia (decreased red blood cell mass) and relative anemia (higher plasma volume).
Erythron iron, crucial for hemoglobin synthesis, is supplied via transferrin, with daily red blood cell destruction and regeneration.
Very little iron is lost from the body, mainly through gastrointestinal cell loss.

Iron Storage and Absorption

Serum Ferritin is an important marker of storage iron levels, normal range being 12 to 300 μg/L.
Ferritin levels reflect tissue iron and are relevant in many disorders.

Folic Acid Deficiency

Management includes oral ferrous iron supplementation (200 mg/day) in three doses between meals.
Megaloblastic anemia is characterized by macrocytosis and normoblastic marrow with large red blood cells.
Non-megaloblastic macrocytic anemias can occur due to early erythrocyte release, hypothyroidism, excessive alcohol intake, or liver disease.
Some folate deficiency cases may result in red cell fragmentation, mimicking microangiopathic hemolytic anemia.

Absolute Polycythemia

Defined as an increase in total red cell mass within the body.

Porphyria Cutanea Tarda (PCT)

PCT is typically acquired and may involve inherited enzyme deficiencies.
Environmental and genetic factors influence the expression and symptoms of porphyria.
Triggers such as excess iron, liver disease, estrogen medication, smoking, or high alcohol consumption can lead to increased heme demand, causing symptoms of porphyria.

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Description

Learn about anemia diagnosis, hemoglobin concentration, hematocrit, and reference intervals for age, sex, and geographic location. Understand absolute anemia, relative anemia, and the role of erythron iron in hemoglobin synthesis.