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Liver storage - Coggle Diagram
Liver storage
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:star: Ferritin: large spherical protein made of 24 noncovalently linked subunits, form shell surrounding central core
core containing up to 5000 atoms of iron, ferritin found in cytoplasm of cells but also found in serum - concentration of ferritin is directly proportional to total iron stores in body
:star: Ferritin Excess:
Excess iron storage disorders:
- hereditary haemochromatosis - iron build up in body
- haemolytic anaemia
- sideroblastic anaemia
- multiple blood transfusions
- iron replacement therapy
Non-iron overload:
- liver disease
- some malignancies
- significant tissue destruction
- acute phase response: inflammation, infection, autoimmune disorders
:star: Ferritin Deficiency:
Low ferritin is iron deficiency - anaemia
< 20 µg/L indicates depletion
< 12 µg/L suggests complete absence of stored iron
:star: Clotting Factors:
Intrinsic pathway activated by contact
Extrinsic pathway activated by FVII coming in contact with tissue factor
Initiates cascade - results in fibrin clot formation
Produced in liver:
- I (fibrinogen)
- II (prothrombin)
- IV
- V
-VI
-VII
Performance of clotting pathways:
Measured using prothrombin time (PT - extrinsic pathway)
International normalised ratio (INR)
Activated partial thromboplastin time (aPTT - intrinsic pathway)Prolonged PT may indicate deficiency in synthetic capacity of liverProlonged PT not specific for liver disease:
- DIC, severe GI bleeding, some drugs, Vit K deficiency
:star: Vitamins: usually provided in diet, characteristic disorders when someone is vitamin deficient
Recommended daily allowance - RDA
Adequate intake, AI, where no evidence to determine RDA
Vitamins act as:
- gene activators
- free-radical scavengers
- coenzymes or cofactors in metabolic reactions
Excessive vitamin ingestion can result in toxicity
Vitamins B and C:
Water soluble
Vitamins A,D,E and K
Fat soluble
Water soluble vitamin pass more readily through the body so require more regular intake than fat soluble vitamins
:star: Iron Metabolism: dietary iron, duodenum -- plasma transferrin:
Iron utilisation - bone marrow -> circulating erythrocytes -> reticuloendothelial macrophages, muscle (myoglobin)
Storage iron - liver parenchyma
Iron loss - sloughed mucosal cells, desquamation, menstruation, other blood loss