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Microcytic Anemia: Sideroblastic Anemia – Red Blood Cell Pathology

by Carlo Raj, MD
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    Students always confuse the amount of iron in microcytic anemia. What does that even mean? You shall see in sideroblastic. There is absolutely no issue with iron deficiency, yet it’s microcytic. Let’s begin with MCV being less than 80 and we also began here with a pretty prolonged and elaborate conversation and discussion of things that you need from biochemistry so that the pathology makes sense. Not to worry, I’m going to walk you through every step of this. So that by the time you go from start to finish, you have a complete picture of what sideroblastic anemia means and along the way, you are then – I am then going to point out to you a couple of other interesting points of what’s known as you porphyria pathway and porphyria diseases from biochem. Okay. First and foremost, please know where we are. We’re in the bone marrow and the fact that you even have a nucleus in an RBC is -- Well, what kind of RBC would this be? Tell me about your RBC that’s in circulation. It is naked. What does that mean? It has no nucleus and it has no mitochondria. The only method by which iron can then derive its energy from would be anaerobic glycolysis and it would then protect itself by utilizing what’s known as your G6PD pathway and your hexose monophosphate. Are we clear about what a normal RBC should look like? And I showed you a picture earlier in iron deficiency with the normal, where it looks pretty transparent. The only thing that it truly contains is hemoglobin. Okay. Enough discussion about normal RBC. So this is a nucleated RBC and if you were to find this in your circulation, that definitely would mean pathology. But here, let’s go with...

    About the Lecture

    The lecture Microcytic Anemia: Sideroblastic Anemia – Red Blood Cell Pathology by Carlo Raj, MD is from the course Microcytic Anemia – Red Blood Cell Pathology (RBC). It contains the following chapters:

    • Microcytic Anemia - Nucleated RBC in Bone Marrow
    • Sideroblastic Anemia - Etiology and Pathogenesis
    • Sideroblastic Anemia - Iron Studies and Clinical Pathology

    Included Quiz Questions

    1. ALA synthase
    2. ALA dehydratase
    3. Ferrochelatase
    4. Uroporphyrinogen decarboxylase
    5. Porphobilinogen deaminase
    1. Pyridoxine
    2. Riboflavin
    3. Thiamine
    4. Niacin
    5. Cobalamine
    1. Depleting cofactor for rate-limiting enzyme of heme synthesis
    2. Directly inhibiting ferrochelatase
    3. Depleting uroporphyrinogen decarboxylase
    4. Inhibition of aminolevulinic dehydratase
    5. Depleting cofactor for porphobilinogen deaminase
    1. Alcohol
    2. Ferrochelatase deficiency
    3. Iron deficiency
    4. Isoniazid therapy
    5. Lead poisoning
    1. ALA synthase deficiency
    2. Ferrochelatase deficiency
    3. Uroporphyrinogen decarboxylase deficiency
    4. Porphobilinogen deaminase deficiency
    5. ALA dehydratase deficiency
    1. Ferrochelatase and ALA dehydratase
    2. Ferrochelatase and ALA synthase
    3. Porphobilinogen deaminase and uroporphyrinogen decarboxylase
    4. Uroporphyrinogen decarboxylase and ALA dehydratase
    5. ALA synthase and ALA dehydratase
    1. Erythrocyte membrane defect
    2. Pyridoxine deficiency
    3. Myelodysplastic syndrome
    4. Alcohol abuse
    5. Lead poisoning
    1. Myelodysplastic syndrome
    2. None of these
    3. Waldenstrom macroglobulinemia
    4. Lead poisoning
    5. Multiple myeloma
    1. Increased serum iron, increased ferritin, decreased TIBC and increased transferrin saturation
    2. Decreased serum iron, increased ferritin, decreased TIBC and increased transferrin saturation
    3. Increased serum iron, increased ferritin, decreased TIBC and decreased transferrin saturation
    4. Increased serum iron, increased ferritin, increased TIBC and increased transferrin saturation
    5. Increased serum iron, decreased ferritin, decreased TIBC and increased transferrin saturation
    1. Hemochromatosis
    2. Wilson disease
    3. None of these
    4. Prader-Willi syndrome
    5. Plummer-Vinson syndrome

    Author of lecture Microcytic Anemia: Sideroblastic Anemia – Red Blood Cell Pathology

     Carlo Raj, MD

    Carlo Raj, MD


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