Iron Deficiency Anemia Quiz

Iron Study Notes

• Quranic Verses on Knowledge:
  • "O my Lord! Increase me in my knowledge!" (Quran 2014)
  • "O Allah! I ask You for knowledge that is of benefit."

Anemia and Red Blood Cells

• Normal vs. Anemic Red Blood Cells: Images show a normal concentration of red blood cells compared to lower (anemic) concentration.

Colonoscopy and Tumours

• Colonoscopy Visualization: A colonoscopy shows the inner lining of the colon, with a highlighted tumour area

Major Elements in Living Matter

• Essential Elements: Listing of major elements found in living matter: Carbon, Hydrogen, Oxygen, Nitrogen, Phosphorus, Sulphur, Sodium, Potassium, Chloride, Calcium, and Magnesium.

Elements in the Human Body (Percent by Mass)

• Oxygen Percentage: Oxygen makes up 65% of the human body by mass.
• Carbon Percentage: Carbon accounts for 18% of the human body by mass.
• Hydrogen Percentage: Hydrogen makes up 10% of the human body by mass.
• Other Elements: Nitrogen (3%), Calcium (2%), and all other elements combined (2%) comprise the remaining portion.

Elements in Earth's Crust vs. Human body

• Comparison Table: A table comparing the percentage of elements present in the Earth's crust versus elements in the human body. Significant differences illustrate the unique composition of life.

Elements in the Human Body (Percent by Weight)

• Oxygen Percentage: Representing 65.0% of the human body's weight.
• Carbon Percentage: Represents 18.5% of the human body's weight.
• Hydrogen Percentage: Represents 9.5% of the human body's weight.
• Nitrogen Percentage: Represents 3.2% of the human body's weight.
• Calcium Percentage: Represents 1.5% of the human body's weight.
• Phosphorus Percentage: Represents 1.0% of the human body's weight.
• Potassium Percentage: Represents 0.4% of the human body's weight.
• Sodium Percentage: Represents 0.2% of the human body's weight.
• Chlorine Percentage: Represents 0.2% of the human body's weight.
• Magnesium Percentage: Represents 0.1% of the human body's weight.
• Sulfur Percentage: Represents 0.04% of the human body's weight.

Trace Elements

• List of Trace Elements: A list of trace elements essential for human health: Iron, Zinc, Copper, Cobalt, Iodine, Fluoride, Chromium, Manganese, Molybdenum, Selenium, Vanadium, and Silicon.

Trace Element Functions

• Disease Prevention: Some trace elements are crucial for preventing disease.
• Oxygen Transport: Iron is necessary for oxygen transport.
• Hormone Production: Iodine is essential for thyroid hormone production.

Iron (Fe)

• Atomic Number: Iron's atomic number is 26.

Iron Learning Objectives

• Functions: Function of iron.
• Dietary Sources: Dietary sources of iron.
• Recommended Daily Intake: Recommended daily intake of iron.
• Distribution in the Body: Iron's distribution in the body.
• Absorption: Absorption of iron.
• Transport, Storage & Elimination: Transport, storage, and elimination of iron.
• Deficiency & Overload: Iron deficiency and overload, their investigations.

Iron Sources

• Animal Products (Fe++): Liver, Meat, Fish, Eggs.
• Plant Products (Fe+++): Cereal, Pulses, Soya bean, Green leafy vegetables, Dried fruit, Fresh fruits, and Potatoes.

Anemia Recommendations

• Vitamin B12: Animal source foods.
• Vitamin C: Rich fruits for dessert, boosting iron absorption.
• Dried Fruit & Nuts: Between meals.
• Green Vegetables: Provide folic acid for red blood cells.

Total Iron in the Body

• Total Amount: 4 grams.

Iron Distribution in the Body

• Hemoglobin: 2.5 grams
• Stores (Ferritin): 1.0 gram
• Stores (Hemosiderin): 0.7 gram
• Tissues (Myoglobin): 0.5 gram
• Tissues (Haem Enzymes): 0.32 gram
• Tissues (Non-Haem Enzymes): 0.08 gram
• Other Tissues: 0.1 gram

Daily Iron Metabolism

• Dietary Intake: 12mg.
• Small Intestine Absorption: 1mg.
• Feces Elimination: 11mg.
• Plasma Iron Turnover: 35mg.
• Tissue Store: 1g.
• Bone Marrow: 20mg.
• All Cells: 14mg.
• Utilization: Plasma iron turnover of 35mg.
• Output and Losses: 1mg.

Iron Absorption (Feedback Control)

• Stored Iron Amount: Increases with pregnancy and iron deficiency.
• Bone Marrow Activity: Increases with hemolysis and non-iron deficiency anemia; or providing Vitamin B12 for pernicious anemia.
• Oxygen Tension: Increases in intestinal cells with hypoxia.

Factors Affecting Iron Absorption

• Iron Form: Fe++ is better absorbed than Fe+++.
• Insoluble Complexes: Phytates, Phosphates, Oxalates, and Carbonates decrease absorption.
• Promoters: Vitamin C, Sugars, Citric acid, Amines, and animal foods increase absorption.
• Inhibitors: Alcohol, Tea (tannins), antacids, malabsorption, acute fever, and chronic infections decrease absorption.

Factors Affecting Non-Haem Iron Absorption

• Improving Absorption: Cauliflower, Tomatoes, Kiwi fruit, Meat, Fish, Poultry, Tamarillos, Citrus Fruit.
• Inhibiting Absorption: Tannins (in tea), Dietary Fibre, Soy proteins, Phytates (in whole grains), Polyphenols, and Oxalate.

Iron Absorption Investigations

• Normal Ranges (for blood tests):
  • Plasma Iron: 0.8-1.6 mg/l.
  • TIBC: 3.1-5.1 mg/l.
  • Transferrin: 3-4 g/l.
  • Ferritin: > 10 ng/ml..
• Other Investigations: Free erythrocyte protoporphyrin, hemoglobin, erythrocyte indices, and biopsy for confirmation.

Iron Stores

• Ferritin and Hemosiderin: Stored in liver, spleen, and bone marrow.

Daily Iron Elimination

• Feces: 90% of dietary iron (11mg/day).
• Urine: Desquamated epithelial cells, WBC, and RBC (0.1mg/day).
• Sweat: Desquamated skin cells (0.1mg/day).
• Menstrual Blood: 20-30 mg/month.
• Pregnancy: 400 mg/pregnancy amount.

Recommended Daily Iron Intake

• Children (to puberty): 10 mg.
• Men: 10 mg.
• Postmenopausal Women: 10 mg.
• Adolescents: 10-20mg.
• Women (Reproductive): 20 mg.
• Pregnancy: 30 mg.

Iron Deficiency Anemia

• MCV: Reduced.
• MCH: Reduced.
• MCHC: Reduced or Normal.
• Iron: reduced or normal.
• TIBC: Increased.
• Transferrin Saturation: Reduced.
• Ferritin: Reduced.
• RDW: High.
• Reticulocytes: High.
• Platelets: Normal/Low.
• WBC: Normal/Low.
• Smear: Hypochromia, anisocytosis, microcytosis, poikilocytosis

Iron Deficiency Signs and Symptoms

• Cognitive: Reversible alterations in behavior.
• Attention Span: Decreased attention span.
• Motor Development: Impaired motor development.
• Physical Activity: Decreased physical ability
• Fatigue: Fatigue.
• Irritability: Irritability.
• Anorexia: Anorexia
• Thermoregulation: Abnormalities in thermo-regulation.
• Scholastic Achievement: Low scholastic achievements.
• Immune Response: Low immunological and defensive responses.

Iron Overload

• Iron Poisoning: Iron-related issues.
• Hemochromatosis: Genetic and/or acquired condition involving iron accumulation.
• Nutritional Iron Overload (Siderosis): Iron overload from various causes/conditions
• Organs Affected: Liver, Pituitary gland, Thyroid, Adrenal gland, Heart, Heart and circulation, and Pancreas.

Iron Overload Causes

• Genetic Disorder (HH): Primary (Hereditary) hemochromatosis.
• Acquired Causes: Iron-loading anemia (e.g., with transfusions), excessive dietary iron intake, chronic liver disease (e.g., alcoholic liver disease, hepatitis B/C).

Hemochromatosis Investigations

• Fasting Transferrin Saturation: If raised, above 60% in males and 50% in females, then tests are required for more in-depth analysis.
• Ferritin: Increased or normal ferritin levels should be investigated.
• Genotyping: Testing for the HFE gene (genetic test for HH).
• Biopsy & Hepatic Iron Index: Liver Biopsy for a thorough investigation or analysis

Symptoms Leading to Iron Accumulation

• No Symptoms: No symptoms in the early stages.
• Symptoms over Time: Arthritis, abnormal liver function, diabetes, chronic abdominal pain, severe fatigue, early menopause, loss of libido, impotence, dyspnea, cardiomyopathy, arrhythmia, cirrhosis, liver cancer, heart failure, and bronze skin pigmentation. (Symptoms are progressive).
• End Stage: Bronze Diabetes