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    Iron Deficiency Anemia

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    KevinEustaquio
    Kris, a 28-year-old pregnant woman, is experiencing symptoms of fatigue, shortness of breath, leg cramps and sore tongue. Her physician suspects iron deficiency anemia based on her physical exam and orders blood tests. The blood results show low hemoglobin, hematocrit, serum iron and MCV levels consistent with iron deficiency anemia. Iron deficiency anemia occurs when there is inadequate hemoglobin due to low iron levels and is common in women, especially pregnant women, due to blood loss from menstruation and increased iron needs during pregnancy.

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    Iron Deficiency Anemia

    Uploaded by

    KevinEustaquio
    717 views33 pages
    Kris, a 28-year-old pregnant woman, is experiencing symptoms of fatigue, shortness of breath, leg cramps and sore tongue. Her physician suspects iron deficiency anemia based on her physical exam and orders blood tests. The blood results show low hemoglobin, hematocrit, serum iron and MCV levels consistent with iron deficiency anemia. Iron deficiency anemia occurs when there is inadequate hemoglobin due to low iron levels and is common in women, especially pregnant women, due to blood loss from menstruation and increased iron needs during pregnancy.

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    iron deficiencty anemia in pregnancy

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    iron deficiency anemia

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    Kris, a 28-year-old pregnant woman, is experiencing symptoms of fatigue, shortness of breath, leg cramps and sore tongue. Her physician suspects iron deficiency anemia based on her physical exam and orders blood tests. The blood results show low hemoglobin, hematocrit, serum iron and MCV levels consistent with iron deficiency anemia. Iron deficiency anemia occurs when there is inadequate hemoglobin due to low iron levels and is common in women, especially pregnant women, due to blood loss from menstruation and increased iron needs during pregnancy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    717 views33 pages

    Iron Deficiency Anemia

    Uploaded by

    KevinEustaquio
    Kris, a 28-year-old pregnant woman, is experiencing symptoms of fatigue, shortness of breath, leg cramps and sore tongue. Her physician suspects iron deficiency anemia based on her physical exam and orders blood tests. The blood results show low hemoglobin, hematocrit, serum iron and MCV levels consistent with iron deficiency anemia. Iron deficiency anemia occurs when there is inadequate hemoglobin due to low iron levels and is common in women, especially pregnant women, due to blood loss from menstruation and increased iron needs during pregnancy.

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    At a glance
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    The key takeaways are that hemoglobin carries oxygen in the blood and is composed of heme and globin. Iron is an important element for hemoglobin synthesis and oxygen transport. Iron deficiency can lead to anemia.

    Hemoglobin is composed of heme and globin. Heme contains iron and mediates oxygen binding. Globin surrounds and protects heme.

    Iron is stored in the liver and bone marrow. Dietary iron is absorbed in the small intestine and transported bound to transferrin in the blood to erythrocyte precursors for hemoglobin synthesis or storage as ferritin.

    CASE DISCUSSION:

    IRON DEFICIENCY ANEMIA

    Overview
    I. Hemoglobin II. Iron III. Anemia IV. Iron Deficiency Anemia V. Case A.) Patients Profile B.) Etiology C.) Pathophysiology D.) Lab Results V. Answers to Questions

    I. Hemoglobin
    -Carries oxygen in the circulation

    -Formed from combination of heme and globin


    Heme - prosthetic group that mediates reversible by hemoglobin. binding of iron

    Globin - protein that surrounds and protects the heme molecule.

    -One of its important elements in synthesis is Fe (Iron)

    I. Hemoglobin

    II. Iron
    - Important in formation of hemoglobin and other enzymes - Assists in transportation of oxygen in RBC

    II. Iron
    Exists as either Fe(III), usually on alkaline solutions, and or Fe(II) on acidic solutions Fe(II) is the form used by the body.

    III. Anemia
    -Decrease in oxygen carrying capacity of the blood -Caused by:
    -decrease in RBC number -inadequate hemoglobin content in RBCs -abnormal hemoglobin in RBC

    IV. Iron Deficiency Anemia


    - Condition characterized by a defect in hemoglobin synthesis due to decreased iron intake/absorption. - Characterized by:
    abnormally small blood cells (microcytic) color loss due to decreased amount of hemoglobin (hypochromic)

    - Reduced capacity of the blood to deliver oxygen to body cells and tissues.

    V. Case
    Kris is a 28-year-old attorney living in Dagupan City. Kris is in the second trimester of pregnancy with her first child, and though her pregnancy had been progressing normally, recently she has noticed that she tires very easily and is short of breath from even the slightest exertion. She also has experienced periods of light-headedness, though not to the point of fainting. Other changes she has noticed are cramping in her legs, a desire to crunch on ice, and the fact that her tongue is sore. She doubts that all of these symptoms are related to one another, but she is concerned, and she makes an appointment to see her physician. Upon examining Kris, her physician finds that she has tachycardia, pale gums and nail beds, and her tongue is swollen. Given her history and the findings on her physical exam, the physician suspects that Kris is anemic and orders a sample of her blood for examination. The results are shown below:

    Blood Sample Results. Red Blood Cell Count Hemoglobin (Hb) Hematocrit (Hct) Serum Iron Mean Corpuscular Volume (MCV) Mean Corpuscular Hb Concentration (MCHC) Total Iron Binding Capacity in the Blood (TIBC) 3.5 million/mm3 7 g/dl 30% low low low high

    (risk factors)

    IDA
    increased body load diet

    history of menstruation

    increased nutritive and blood requirement

    insufficient iron diet

    Low iron supply

    Low iron supply

    Low hemoglobin

    Failure of formation of ETC complexes

    Low Oxygen supply Weakened metabolism of cells

    obvious manifestations inefficient cellular processes (severe changes in epithelial (repair , growth, reproduction) and mucosal linings pale skin, brittle nails, swollen tongue, etc.)

    Low oxygen supply

    shortness of breath

    faster heart pumping for oxygen supply

    taking over of anaerobic glycolysis

    light headedness

    tachycardia

    build up of lactic acid on muscles muscle cramps

    VI. Answers to Questions


    1) Describe the structure of a molecule of hemoglobin and explain the role played by iron in the transport of oxygen.

    Hemoglobin Structure
    Hemoglobin consists of:
    1). Globin protein component composed of two sets of two different polypeptide chain. (alpha and beta chain) 2). Four molecules of the nitrogenous substance protoporphyrin IX. 3). Four iron atoms in the ferrous state (Fe 2+) that combine with protophyrin IX to form 4 heme molecules. 4). One 2,3 diphospoglycerate molecule as a transient resident in the center of the Hb unit.

    (internet hemoglobin structure)

    Internet protoporphyrin IX + fe + globin)

    (internet Perultz T and D form of hemoglobin + 2,3 DPG)

    Iron in Oxygen transport


    Irons role in oxygen transport
    - attaches the Oxygen molecule via weak coordination covalent bonds - in conformational changes of the heme, due to attachment of 2,3 diphosphoglycerate, the orbital of the iron available for binding with the oxygen becomes less available, thus facilitating in the easy release of oxygen molecule.

    VI. Answers to Questions


    2) How is iron stored and transported in the body?

    Iron locations
    Present through out the body
    Mostly found in intracellular space of liver and bone marrow

    Iron source and storage -dietary iron ingested as Fe(III) or Fe(II), but only Fe(II) can be
    used. Fe (III) reduced to Fe (II) due to acidic gastric pH

    - absorption occurs in stomach, duodenum and jejunum.


    - intestinal mucosa oxidizes absorbed iron into Fe(III) state, then stores temporarily as ferritin.

    Iron transport
    1) Fe (III) released from mucosal cells
    2) Attaches to transferrin for transport in blood 3) Iron transferrin complex bind to receptors of erythrocyte precursors. 4) Erythrocyte precursor engulfs complex and delivered to mitochondria for heme synthesis or as crystalline aggregates of ferritin for storage

    VI. Answers to Questions


    3) What is Iron Deficiency Anemia (IDA) and how frequently does it occur?

    Iron Deficiency Anemia


    -anemia caused by inadequate hemoglobin content in RBCs

    Occurrence
    approximately 20% of women, 50% of pregnant women, and 3% of men are iron deficient.

    VI. Answers to Questions


    4) What are the most common causes of IDA?

    Causes
    - insufficient iron intake or absorption
    - blood loss
    1) intense menstruation 2) hemmorhage from trauma

    VI. Answers to Questions


    5) Why are women more prone to IDA than men?

    Women more prone - lower supply of iron than men

    - lose more iron due to blood loss during menstruation

    Laboratory Tests
    1. Red Blood Cell Count - Test that indicates the number of RBC. 2. Hemoglobin - Provides an estimate of the oxygen carrying capacity of blood. 3. Hematocrit - Commonly used synonymously with PCV to denote the percentage of erythrocytes in a known volume. 4. Serum Iron - Serum Iron may not always be necessary to the differential diagnosis of iron metabolism, it is still used for its purpose. It is particularly helpful in cases where the diagnosis is not obvious from other lab tests. 5. Mean Corpuscular Volume -Indicates the average volume of a single erythrocyte in a given blood sample. 6. Mean Corpuscular Hgb -Indicates the average weight or Hgb per erythrocyte of any specimen. Values of 31 37 g/dL are considered normochronic. 7. Total Iron Binding Capacity -Used to diagnose an iron metabolism disorder.

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