Anemia in physiology

for my class

1. Anemia
Physiology
Project
Kazan State Medical University
By:Mahi

2. ANAEMIA
Definition:
 Anemia is defined as a
decreased O2 carrying
capacity due to quantitative
and qualitative Reduction in
RBC counts and Hemoglobin
levels.
By:Mahi

3. ANAEMIA
ANAEMIA is labelled
when Hb is less than
13gm/dl in Males
11 gm/dl in Females
15gm/dl in Newborn.
By:Mahi

4. By:Mahi

5. MORPHOLOGICAL CLASSIFICATION:
normochromic
By:Mahi

6. Etiological Classification
By:Mahi

7. DUE TO DECREASED RBC
PRODUCTION.
IRON DEFICIENCY
ANAEMIA.
In women of
reproductive age group
(20-45 yrs)
In periods of active
growth of infancy,
childhood & adolescence
By:Mahi

8. IRON METABOLISM
Total body contains 4-5
gms
Forms –
Haemoglobin 70%
Storage iron 20-23% 2/3
rd

Ferritin & 1/3
rd

Haemosiderin.
Myoglobin in red muscles
5%
Intracellular enzymes 2-3%
By:Mahi

9. DAILY REQUIREMENTS &
SOURCES
5-10 mg/day in Males
20 mg/day in
Females.
40 mg/day in
Pregnant & lactating
women.
Meat, liver, egg, green
leafy veg, Jaggery &
whole wheat.
By:Mahi

10. By:Mahi

11. IRON
ABSORPTION
Mainly in duodenum &
upper jejunum.
MECHANISM
Transport across brush
borders
Haeme iron
Non-haeme iron.
Fate in Enterocytes.
Transport in plasma.
By:Mahi

12. IRON ABSORPTION
Transport across brush
borders.
Absorption of Haeme
form
Absorption of Non-
haeme form
Fate in Enterocytes.
Transport in plasma.
By:Mahi

13. Factors affecting iron
absorption
Form of dietary iron –
haem iron
Non-haem iron – ferrous form (Fe2+) > ferric form
(Fe3+)
Meat & fish ,Human breast milk ,Acid gastric
juice – enhances absorption.
Dietary factors – Phytates , phosphates, calcium,
egg white, phenols, tea, coffe wine reduces.
Iron stores in body – Negative feedback effect.
By:Mahi

14. STORAGE OF IRON
As ferritin
As haemosiderin.
By:Mahi

15. REGULATION OF BODY IRON
Mucosal block theory of absorption.
Saturation of apoferritin & apotransferrin
Decresed rate of apoferritin synthesis.
Role of specific iron receptors in brush borders.
By:Mahi

16. By:Mahi

17. By:Mahi

18. APPLIED ASPECTS.
Iron deficiency- iron
deficiency Anaemia
Iron excess –
Haemosiderin
accumulation –
Haemosiderosis –
damages tissue –
Haemochromatosis.
By:Mahi

19. CAUSES OF IRON DEFICIENCY
ANAEMIA.
Inadequate dietary
intake.
Increased loss of iron.
Increased demand of
iron.
Decreased absorption.
By:Mahi

20. Megaloblastic Anaemia
Megaloblast –
abnormally large cells
of Erythroid series.
Caused by defective
DNA synthesis due to
deficiency of Vit B12 &
Folic acid.
By:Mahi

21. Vit B 12 (Extrinsic Factor)
Vit B12 –
Cyanocobalamin or
extrinsic factor.
Daily need – 1-2 μg.
Sources – Milk, Meat,
Liver of Animals
Also synthesized by
bacterial Flora.
By:Mahi

22. Vit B 12 (Extrinsic Factor)
Absorption – need
Intrinsic Factor Of Castle ,
a glycoprotein secreted by
parietal cells of gastric
mucosa.
With it form Intrinsic
Factor- Cyanocobalamin
complex
Bound to sp receptors in
ileum & absorbed by
Endocytosis.
By:Mahi

23. Vit B 12 (Extrinsic Factor)
Transport – in blood
transported by
combining with
Transcobalamin-II
Storage – In liver &
Muscle
Role – required for
synthesis of DNA &
maturation of nucleus &
cell.
By:Mahi

24. Folic Acid
Folic acid –
Pteroylglutamic acid.
Daily requirement –
100 μg.
Sources – leafy veg,
pulses, yeasts, liver.
From breakdown of
Polyglutamate to
Monoglutamates.
By:Mahi

25. Aetiology.
Due to vit B12
deficiency
Causes –
Inadequate dietary
intake
Malabsorption due to
gastric cause
Intestinal Cause.
By:Mahi

26. Addisonian Pernicious
Anaemia.
Aetiology – vit B12
deficiency due to
failure of secretion of
Intrinsic Factor by
stomach due to
Autoimmune
Atrophy of Gastric
Mucosa.
Features.
Features of
Megaloblastic anaemia
Anti-intrinsic factor
antibodies.
Schilling test.
(abnormal vit B12
absorption test
corrected by addition
of Intrinsic Factor)
By:Mahi

27. Clinical Features:
General features of Anemia
Pallor, Weakness, Lethargy,
Breathlessness on exertion
Palpitations  heart failure  pedal edema
Special features :
Angular cheilitis, Atrophic glossitis,
Oesophageal atrophy/web  Dysphagia,
Koilonychia, brittle nails, gastric atrophy.
By:Mahi

28. Special features :
By:Mahi

29. LAB FINDINGS
Blood picture & red cell
indices.
Hb Decreased
RBC – Microcytic,
Hypochromic in iron
deficiency
Megaloblastic in vit B12 &
FOLIC ACID deficiency
Red cell indices – MCV,MCH
& MCHC Decreases
By:Mahi

30. BONE MARROW FINDINGS.
Iron deficiency
anaemia
Marrow Cellularity –
Erythroid Hyperplasia.
Erythropoiesis –
Normoblastic
Marrow Iron –
Deficient.
Megaloblastic
anaemia.
Marrow cellularity –
Megaloblastic
Hyperplasia.
Marrow iron – by
Prussian Blue staining
increase in size & no of
iron granules.
By:Mahi

31. THANK
YOU
By:Mahi