Iron-deficiency anemia Backgroud Backgroud Hb Iron: Hb red meat supply: red meat absorption & storage: Fe Vit.C HCl Fe ++ Fe +++ t&s Fe ++ Fe Vit.C HCl Fe ++ Fe +++ t&s Fe ++ diagnosis: PT/TIBC < 10%(35%) Symptoms: fatigue, pica
Megaloblastic anemia L-MCoA ScCoA LIPIN FH2 E Folate E 5-MFH 4 CH3 B12 B12 E FH4 C-FH4 CH3-B12 dUMP dTMP DNA C Homocysteine Methionine A: B12 B: 半胱氨酸 蛋氨酸 甲基丙二酰 CoA 琥珀酰 CoA B12 B12 E 尿嘧啶脱氧核苷酸 胸腺嘧啶脱氧核苷酸
Megaloblastic anemia Folic acid RNA: DNA Megaloblastic anemia absorbed in intestine: 5-MFH 4 5-MFH 4 liver Therapy B 12 folic acid(calcium leucovorin)+ B 12
Megaloblastic anemia B 12 B 12 Background mainly from animal absorbed with IF Storage in liver 5-MFH4 B12 FH4 lipin synthesis of nerves
Megaloblastic anemia Deficiency FH4 Megaloblastic anemia & CNS symptoms Etiology Some gastrointestinal diseases IF therapy B 12 & folic acid use together. B 12 & folic acid use together.
Depression of the bone marrow Depression of the bone marrow Anemia associated with chronic renal failure (CRF) Anemia associated with chronic renal failure (CRF)
Anemia from CRF Erythropoietin (EPO) Effect: RBC Uses: CRF, Iron deficiency, Marrow injury, tumors, AIDS. Agent: ESPO
WBC stimulants---CSF G-CSF: PMN GM-CSF: PMN,MO,Macrophage,PLT USEs Marrow inhibited situations, Chemistry or Radiopraxis Marrow inhibited situations, Chemistry or Radiopraxis AIDS AIDS anemia anemia
B.V. increasing Agents (Dextran): Features (Dextran): Colloid Osmotic Pressure of plasma excretion is slow no toxicity no antigenicity
Where are the action sites of Anticoagulants and Thrombolytic agents respectively ? Which kind of drug would you choose for an AMI (<8hr.s) patient? A. Antiplatelets B. Coagulants C. Thrombolytics D. Anticoagulants
Questions Which factors formation dependend on V-K? And which can be inactivated by heparin? A. I A’. Ia B. II B’. IIa C. VII C’. XIa D. IX D’. IXa E. X E’. Xa F. XII F’. XIIa
Questions 1.What is the active form of folic acid? 2. The functions of B12. 3. Why some patients will get anemia after stomach excision?
Questions Which would u choose for the patients with Megaloblastic anemia? Iron agents Iron agents Folic acid only Folic acid only G-CFS G-CFS Folic acid & B12 Folic acid & B12