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Iron Metabolism

Iron   metabolism Curriculum •       List the iron containing haeme and non-haeme   proteins   and describe their functions •       Describe the intestinal absorption of iron and distribution kinetics in the body •       Describe the process of haeme biosynthesis and catabolism •       Describe iron deficiency anaemia and acute intermittent porphyria •       Describe the diagnostic test for iron states (serum iron, serum iron binding capacity, serum ferritin) •       Describe and classify porphyria •       Describe the causes, diagnosis and management of porphyria Heme containing proteins & enzymes Hemoglobin: transport of oxygen in blood Myoglobin: storage of oxygen in muscle Cytochrome c: involvement in oxygen transport chain Catalase/Peroxidase: antioxidant enzymes that protect cells from reactive oxygen species(ROS) Tryptophan pyrrolase: oxidation of tryptophan Cytochrome P 450 : for hydroxylation of xenobiotics Non-heme, iron-containing pro

Chronic Myeloproliferative Disease

Polycythemia, or erythrocytosis, is an increase in the blood concentration of red cells, which usually correlates with an increase in the hemoglobin concentration •        Classification –       Relative –       Absolute •        Relative polycythemia –       Hemoconcentration caused by a decrease in plasma volume –       Results   from any cause of dehydration •          Water deprivation •          Prolonged vomiting •        Diarrhea •        Excessive use of diuretics •        Absolute polycythemia –       Increase in the total red cell mass –       Primary: increase in red cell mass results from an autonomous proliferation of the myeloid stem cells. Normal or low erythropoietin levels. •          Secondary: Red cell progenitors proliferate in response to an increase in erythropoietin •        Pathophysiologic Classification of Polycythemia •        Relative

Vascular System

ARTERIAL SYSTEM Thoracic Aorta •        T4 – T12 •        Branches –       Pericardial –       Bronchial 2 left bronchial –       Esophageal 4-5 –       Mediastinal –       Posterior intercostal for lower 9 ICS                               upper 2 from costo-cervical trunk –       Superior phrenic –       Subcostal Abdominal Aorta •        Extent – aortic   hiatus T12 – L4 ( line joining highest point of iliac crest) •        Branches –       Visceral •        unpaired –       Celiac trunk –       Superior mesenteric artery –       Inferior mesenteric artery •        paired –       Middle suprarenal artery –       Renal artery –       Gonadal artery –       Posterior branches •        Inferior phrenic   arteries •        Lumbar arteries •        Median sacral artery •        Internal Iliac Artery Branch of CIA (external and internal iliac arteries) IIA

Neoplastic Proliferation of WBC

White blood cells ·          Myeloid –         Myeloblast –         Promyelocyte –         Myelocyte –         Metamyelocyte –         Band –         Neutrophil,eosinophil, basophil •           Lymphoid –         Lymphocyte (B and T) and plasma cells –         Neoplastic proliferation of white cells Classification according to the origin of tumor cells: –         Lymphoid neoplasms •           Lymphocytic Leukemia •           Lymphoma (Hodgkin and non Hodgkin) •           Plasma cell dyscrasia –         Myeloid neoplasms •           Acute myelogenous leukemia •           Myelodysplastic syndromes •           Chronic myeloproliferative disorders –         Histiocytoses: proliferative lesion of macrophages and dendritic cells •           Langerhans cell histiocytoses Lymphoid Neoplasms •           Leukemia: lymphoid neoplasm characterized by a malignant neoplastic proliferation and accumulation of immature