IRON :
IRON Total body content of Iron is 3-5 gm.
70% in Erythrocytes (in Hb)
5% in Myoglobin
Remaining as other hemoproteins, like cytochromes, catalase, xanthine oxidase, tryptophan pyrollase, peroxidase etc.
Non hemo proteins like transferrin, ferritin & Hemosiderin
Biochemical functions :
Biochemical functions As imp. components of Hb & Mb helps in transport of O2
As imp. components of cytochromes & non heme substances helps in OXIDATIVE PHOSPHORYLATION
Peroxidase – required for phagocytosis
Daily requirement :
Daily requirement Adult - 10 mg/day
Menstruating women - 18 mg/day
Pregnant & Lactating mother – 20-40 mg/day
Sources
Rich Source – Liver, heart, kidney, spleen
Good Sources: Spinach, bananas, apples,
Egg yolk
Poor Sources: Milk, wheat
Absorption :
Absorption
Iron is absorbed in Ferrous state. In food stuff Iron is present in
Ferric form which is converted to Fe++ by Ascorbic acid or cysteine.
Factors affecting Iron absorption
Acidity, Ascorbic acid & cysteine levels
High phosphate diet
Phytic acid & Oxalates
Cu deficiency
Normal Serum Iron level is 65 – 170 mg/100ml :
Normal Serum Iron level is 65 – 170 mg/100ml Iron level in blood is maintained at the level of absorption only.
It is not excreted in Urine.
In Iron levels – Iron absorption
In Iron levels – Iron absorption
Disorders :
Disorders Iron deficiency anemia
Defect in absorption
Nutritional disorder
Chronic blood loss
Lead poisoning
Hook worm Infestation
Repeated Pregnancies
Nephrosis
Slide 8:
2. Hemosiderosis
3. Hemochromotosis
Slide 9:
Major Elements:
Daily requirement more than 100mg.
- calcium, Magnesium, Phosphorus, Sodium, Potassium, Chlorine, Sulphur.
Minor Elements:
Daily requirement less than 100mg.
- Iron, Iodine, Cu, Mn, Zn, Co, Mo, Se & F.
Calcium :
Calcium Total content of Ca in our body is around 1 – 1.5 kg
Sources:- Milk – Good source
Egg
Fish Medium source
Vegetables
Cereals - poor source
Daily requirement:-
Adults – 500mg
Children – 1200 mg
Pregnant & Lactating women – 1500 mg
Slide 11:
Normal Serum levels 9 -11 mg/dl
Slide 12:
Absorption:
Ca absorption requires a carrier(calbindin)
Factors increase Ca absorption
Vitamin D (Calcitriol)
Parathyroid hormone.
Acidity
Amino acids ( Lysine & Arginine)
Factors decrease Ca absorption
Phytic acid
Oxalates
High phosphate content
Malabsorption syndromes.
Ca is mainly extracellular.Ca influx into the cell by Ca++/Na+ exchange expulsion by Ca++/H+ ATPase dependent pump. :
Ca is mainly extracellular.Ca influx into the cell by Ca++/Na+ exchange expulsion by Ca++/H+ ATPase dependent pump. Functions
Activation of Enzymes
Calmodulin is a regulatory protein 4 Ca++ ions binds to calmodulin and activates it.
Ex: 1) Glycogen synthase
2) glycerol – 3- phosphate dehydrogenase
4) Pyruvate dehydrogenase etc.
Ca directly activates enzymes like Pancreatic lipase, enzymes in coagulation .
Slide 14:
2) Ca mediates excitation and contraction of Muscle fibres.
Ca causes neuromuscular Irritability Tetany.
3) Ca helps in transmission of nerve impulses
4) Ca – Calmodulin complex
regulates – Degranulation of
Secretary Vescicles
- Endocytosis
- Cell motility
Slide 15:
5) Secretion of hormones
6) Act as second Messenger in Signal
transduction
7) Decreases Vascular permeability
Ca is a factor in Coagulation
9) In Myocardium Ca++ prolongs systole
10) Bone & teeth
Slide 16:
Factors regulate Blood Ca levels
Vit – D
2) PTH
3) Calcitonin
4) Phosphorus
5) Serum Protein
6) Alkalosis & Acidosis
7) Children & Pregnancy
Kidney threshold.
Slide 17:
PTH – acts on bones
It induces osteoclasts
Osteoclasts release Lactate – Solubulize
& Collagenases
Bone resorption Ca++
Slide 18:
PTH - acts on kidney
PTH causes renal excretion of Ca
renal excretion of Ph
PTH induces formation of Calcitriol, this indirectly increases calcium absorption from Intestine
Slide 19:
Calcitonin Thyroid parafollicular cells.
Decreases serum Ca levels
Decreases the activity of
osteoclasts
Decreases resorption of
bone
Calcitonin secretion is stimulated by Serum Ca levels, gastrin, glucagon and biological amines.
Slide 20:
Serum Proteins :
Hypo albunemia Serum Ca levels but ionized Ca level will be normal.
Alkalosis - favor binding of Ca++ to
proteins
leading to Hypocalcemia
Acidosis - favors Ionization of Ca++
Kidney threshold – Renal threshold for Calcium is 10 mg/dl (Ionized)
Slide 21:
Hypercalcemia
Calcium levels more than 11mg/dl
Major cause Hyper parathyrodism
Parathyroid adenoma
ectopic PTH Secreting
tumor
Osteoporosis
X-rays show punched out lesions on bone.
Urinary Calcium elevated
Recurrent Urinary calculi
Pancreatitis, myositis
Anorexia, muscle weakness.
Slide 22:
Hypocalcemia
Calcium levels less than 8.8 mg/dl.
less then 7.5 mg/dl leads to Tetany.
In tetany – Carpopedal spasm
- Laryngismus
Slide 23:
Renal tubular acidosis
Defect in production of H+ ions in Renal tubules.
Excess urinary loss of Ca, bicarbonate, Sodium, potassium, mg & P.
Phosphorus :
Phosphorus Total body content of phosphorus is 1kg
It is an intracellular ion.
Functions
Formation of bone & teeth
Production of high energy phosphates
Synthesis of coenzymes NAD, NADP.
DNA & RNA Synthesis
Involved in Phosphorylation reactions
Enzymes activation
Regulates Acid Base balance
Slide 25:
Daily requirement
500 mg/day
Sources
Milk - good source
Cereals, nuts & meat - moderate source
Calcitriol Increases Phosphate absorption
Slide 26:
Normal levels
3 – 4 mg/dl in adults
5 – 6 mg/dl in children
Hypo phosphatemia in
Hyper parathyroidism
Rickets.
Slide 27:
A reciprocal relation with Phosphorus and Calcium.
In Renal failure – Phosphorus excretion diminished
- Ca excretion Increase
leading to low Ca levels and high phosphorus level Tetany
Magnesium :
Magnesium Total body magnesium is 20 gm
75% in bones
25% in soft tissues & body fluids. Mainly seen in Intracellular fluid.
Daily requirement
Men - 400 mg/day
Women- 300 mg/day
Sources
Cereals, beans, vegetables, milk & fruits
Absorption requires a specific carrier in intestinal cells.
Normal Serum levels 1.8 – 2.2 mg/dl :
Normal Serum levels 1.8 – 2.2 mg/dl Functions :
Magnesium is the activator of enzymes requiring ATP.
Mg++ is required for proper Neuromuscular function.
Mg++ has a role in Insulin Sentivity
Bone formation
Disorders :
Disorders Hypo magnesemia
Uncontrolled DM
Chronic alcoholism
Liver Cirrhosis
Protein energy Malnutrition
Neuromuscular – hyper irritability
Cardiac arrhythmias
Carpopedal Spasm
(Na+) Sodium :
(Na+) Sodium Total body Sodium is 4000 meq
50% in bones, 40% in ECF & 10% in Soft tissues
It is the major Extracellular cation
Daily requirement
5-10 gm/day
In Hypertensive 1 gm/day is recommended
Sources
Table salt (Nacl) is the major source.
Other sources are vegetables, nuts, eggs and milk.
Functions :
Functions Sodium regulates Osmotic pressure and fluid balance
2) Regulates Acid-base balance (NaH Co3)
3) It is involved in absorption of Glucose, Galactose & Aminoacids.
4) It helps in cell permeability.
Absorption :
Absorption Sodium is readily absorbed in GIT
Normal Serum level is 135-145 meq/L
Excretion
Kidney is the major source of excretion.
Around 800 gm/day is filtered by Glomerulus in that 99% is reabsorbed by tubules.
This reabsorbtion is controlled by Aldosterone
Sweating causes loss of sodium.
Disorders :
Disorders Hyponatremia Sodium levels.
- Diarrhea, Vomiting
- Chronic renal failure
- Addisons disease (adreno cortical Insufficiency)
- Renal tubular acidosis
Mild - head ache, muscle cramps
Moderate & severe - Low Blood pressure & Circulatory failure
Hypernatremia Sodium levels :
Hypernatremia Sodium levels Cushings syndrome
Prolonged administration of steroid hormones (Cortisone, ACTH/Sex hormones)
Severe dehydration (only water)
(Burns, Diabetes Insipidus)
Increased Blood volume, HTN
Potassium :
Potassium Total body potassium is 3500 meq 75% in skeletal muscle
It is the major Intracellular cation
Daily requirement
3-4 gm/day
Sources
Banana, Orange, Potato, beans, Liver etc.
Rich Source is Tender coconut water.
Slide 37:
Functions:
It maintains Intracellular Osmotic pressure
Involves in cardiac & skeletal muscle activities
Mainly K+ required in depolarization & contraction of Heart.
Involved proper transmission of Nerve Impulses
Pyruvate kinase needs K+
Involved in Biosynthesis of proteins
Slide 38:
Normal Serum Potassium
3.5 – 5 meq/L
(Cell contain 100 – 120 meq/L)
Excretion is through urine, during absorption of Na+ there is obligatory loss of K+
Aldosterone K+ excretion
Disorders :
Disorders Hypo kalemia
Serum K+ less than 3 meq/L
Cushing syndrome
Renal tubular acidosis
Tubular necrosis
Metabolic alkalosis
Diarrhea & vomiting
In Diabetic coma treatment with Insulin & Glucose
Diuretics
Muscle weakness
Tachycardia
Cardiac arrest
Hyperkalemia :
Hyperkalemia Addisons disease
Renal failure
Increased hemolysis
Tissue necrosis
Metabolic acidosis
Insulin deficiency
Depression of central Nervous system
Flacid paralysis
Bradycardia & Cardiac arrest
Chlorine :
Chlorine Intake, output & metabolism of Na+& cl- run in parallel
Daily requirement
5-10gm
Sources
table salt – Nacl
grains, leafy vegetables, eggs & Milk.
Excretion is through urine as sodium :
Excretion is through urine as sodium Functions
Regulates Acid Base balance, Osmotic pressure, fluid balance in relation with Na+ & k+
Cl- are necessary for HCL formation
Chloride shift
Salivary amylase is activated by chloride
Slide 43:
Normal serum level is 96-106 meq/L
CSF level is 125 meq/L
Disorders
Hyper chloremia
Dehydration
Cushings syndrome
Severe diarrhea
Respiratory acidosis
Renal tubular acidosis
Hypo Chloremia
Addisons disease
Respiratory alkalosis
Excessive vomiting
IRON Total body content of Iron is 3-5 gm.
70% in Erythrocytes (in Hb)
5% in Myoglobin
Remaining as other hemoproteins, like cytochromes, catalase, xanthine oxidase, tryptophan pyrollase, peroxidase etc.
Non hemo proteins like transferrin, ferritin & Hemosiderin
Biochemical functions :
Biochemical functions As imp. components of Hb & Mb helps in transport of O2
As imp. components of cytochromes & non heme substances helps in OXIDATIVE PHOSPHORYLATION
Peroxidase – required for phagocytosis
Daily requirement :
Daily requirement Adult - 10 mg/day
Menstruating women - 18 mg/day
Pregnant & Lactating mother – 20-40 mg/day
Sources
Rich Source – Liver, heart, kidney, spleen
Good Sources: Spinach, bananas, apples,
Egg yolk
Poor Sources: Milk, wheat
Absorption :
Absorption
Iron is absorbed in Ferrous state. In food stuff Iron is present in
Ferric form which is converted to Fe++ by Ascorbic acid or cysteine.
Factors affecting Iron absorption
Acidity, Ascorbic acid & cysteine levels
High phosphate diet
Phytic acid & Oxalates
Cu deficiency
Normal Serum Iron level is 65 – 170 mg/100ml :
Normal Serum Iron level is 65 – 170 mg/100ml Iron level in blood is maintained at the level of absorption only.
It is not excreted in Urine.
In Iron levels – Iron absorption
In Iron levels – Iron absorption
Disorders :
Disorders Iron deficiency anemia
Defect in absorption
Nutritional disorder
Chronic blood loss
Lead poisoning
Hook worm Infestation
Repeated Pregnancies
Nephrosis
Slide 8:
2. Hemosiderosis
3. Hemochromotosis
Slide 9:
Major Elements:
Daily requirement more than 100mg.
- calcium, Magnesium, Phosphorus, Sodium, Potassium, Chlorine, Sulphur.
Minor Elements:
Daily requirement less than 100mg.
- Iron, Iodine, Cu, Mn, Zn, Co, Mo, Se & F.
Calcium :
Calcium Total content of Ca in our body is around 1 – 1.5 kg
Sources:- Milk – Good source
Egg
Fish Medium source
Vegetables
Cereals - poor source
Daily requirement:-
Adults – 500mg
Children – 1200 mg
Pregnant & Lactating women – 1500 mg
Slide 11:
Normal Serum levels 9 -11 mg/dl
Slide 12:
Absorption:
Ca absorption requires a carrier(calbindin)
Factors increase Ca absorption
Vitamin D (Calcitriol)
Parathyroid hormone.
Acidity
Amino acids ( Lysine & Arginine)
Factors decrease Ca absorption
Phytic acid
Oxalates
High phosphate content
Malabsorption syndromes.
Ca is mainly extracellular.Ca influx into the cell by Ca++/Na+ exchange expulsion by Ca++/H+ ATPase dependent pump. :
Ca is mainly extracellular.Ca influx into the cell by Ca++/Na+ exchange expulsion by Ca++/H+ ATPase dependent pump. Functions
Activation of Enzymes
Calmodulin is a regulatory protein 4 Ca++ ions binds to calmodulin and activates it.
Ex: 1) Glycogen synthase
2) glycerol – 3- phosphate dehydrogenase
4) Pyruvate dehydrogenase etc.
Ca directly activates enzymes like Pancreatic lipase, enzymes in coagulation .
Slide 14:
2) Ca mediates excitation and contraction of Muscle fibres.
Ca causes neuromuscular Irritability Tetany.
3) Ca helps in transmission of nerve impulses
4) Ca – Calmodulin complex
regulates – Degranulation of
Secretary Vescicles
- Endocytosis
- Cell motility
Slide 15:
5) Secretion of hormones
6) Act as second Messenger in Signal
transduction
7) Decreases Vascular permeability
Ca is a factor in Coagulation9) In Myocardium Ca++ prolongs systole
10) Bone & teeth
Slide 16:
Factors regulate Blood Ca levels
Vit – D
2) PTH
3) Calcitonin
4) Phosphorus
5) Serum Protein
6) Alkalosis & Acidosis
7) Children & Pregnancy
Kidney threshold. Slide 17:
PTH – acts on bones
It induces osteoclasts
Osteoclasts release Lactate – Solubulize
& Collagenases
Bone resorption Ca++
Slide 18:
PTH - acts on kidney
PTH causes renal excretion of Ca
renal excretion of Ph
PTH induces formation of Calcitriol, this indirectly increases calcium absorption from Intestine
Slide 19:
Calcitonin Thyroid parafollicular cells.
Decreases serum Ca levels
Decreases the activity of
osteoclasts
Decreases resorption of
bone
Calcitonin secretion is stimulated by Serum Ca levels, gastrin, glucagon and biological amines.
Slide 20:
Serum Proteins :
Hypo albunemia Serum Ca levels but ionized Ca level will be normal.
Alkalosis - favor binding of Ca++ to
proteins
leading to Hypocalcemia
Acidosis - favors Ionization of Ca++
Kidney threshold – Renal threshold for Calcium is 10 mg/dl (Ionized)
Slide 21:
Hypercalcemia
Calcium levels more than 11mg/dl
Major cause Hyper parathyrodism
Parathyroid adenoma
ectopic PTH Secreting
tumor
Osteoporosis
X-rays show punched out lesions on bone.
Urinary Calcium elevated
Recurrent Urinary calculi
Pancreatitis, myositis
Anorexia, muscle weakness.
Slide 22:
Hypocalcemia
Calcium levels less than 8.8 mg/dl.
less then 7.5 mg/dl leads to Tetany.
In tetany – Carpopedal spasm
- Laryngismus
Slide 23:
Renal tubular acidosis
Defect in production of H+ ions in Renal tubules.
Excess urinary loss of Ca, bicarbonate, Sodium, potassium, mg & P.
Phosphorus :
Phosphorus Total body content of phosphorus is 1kg
It is an intracellular ion.
Functions
Formation of bone & teeth
Production of high energy phosphates
Synthesis of coenzymes NAD, NADP.
DNA & RNA Synthesis
Involved in Phosphorylation reactions
Enzymes activation
Regulates Acid Base balance
Slide 25:
Daily requirement
500 mg/day
Sources
Milk - good source
Cereals, nuts & meat - moderate source
Calcitriol Increases Phosphate absorption
Slide 26:
Normal levels
3 – 4 mg/dl in adults
5 – 6 mg/dl in children
Hypo phosphatemia in
Hyper parathyroidism
Rickets.
Slide 27:
A reciprocal relation with Phosphorus and Calcium.
In Renal failure – Phosphorus excretion diminished
- Ca excretion Increase
leading to low Ca levels and high phosphorus level Tetany
Magnesium :
Magnesium Total body magnesium is 20 gm
75% in bones
25% in soft tissues & body fluids. Mainly seen in Intracellular fluid.
Daily requirement
Men - 400 mg/day
Women- 300 mg/day
Sources
Cereals, beans, vegetables, milk & fruits
Absorption requires a specific carrier in intestinal cells.
Normal Serum levels 1.8 – 2.2 mg/dl :
Normal Serum levels 1.8 – 2.2 mg/dl Functions :
Magnesium is the activator of enzymes requiring ATP.
Mg++ is required for proper Neuromuscular function.
Mg++ has a role in Insulin Sentivity
Bone formation
Disorders :
Disorders Hypo magnesemia
Uncontrolled DM
Chronic alcoholism
Liver Cirrhosis
Protein energy Malnutrition
Neuromuscular – hyper irritability
Cardiac arrhythmias
Carpopedal Spasm
(Na+) Sodium :
(Na+) Sodium Total body Sodium is 4000 meq
50% in bones, 40% in ECF & 10% in Soft tissues
It is the major Extracellular cation
Daily requirement
5-10 gm/day
In Hypertensive 1 gm/day is recommended
Sources
Table salt (Nacl) is the major source.
Other sources are vegetables, nuts, eggs and milk.
Functions :
Functions Sodium regulates Osmotic pressure and fluid balance
2) Regulates Acid-base balance (NaH Co3)
3) It is involved in absorption of Glucose, Galactose & Aminoacids.
4) It helps in cell permeability.
Absorption :
Absorption Sodium is readily absorbed in GIT
Normal Serum level is 135-145 meq/L
Excretion
Kidney is the major source of excretion.
Around 800 gm/day is filtered by Glomerulus in that 99% is reabsorbed by tubules.
This reabsorbtion is controlled by Aldosterone
Sweating causes loss of sodium.
Disorders :
Disorders Hyponatremia Sodium levels.
- Diarrhea, Vomiting
- Chronic renal failure
- Addisons disease (adreno cortical Insufficiency)
- Renal tubular acidosis
Mild - head ache, muscle cramps
Moderate & severe - Low Blood pressure & Circulatory failure
Hypernatremia Sodium levels :
Hypernatremia Sodium levels Cushings syndrome
Prolonged administration of steroid hormones (Cortisone, ACTH/Sex hormones)
Severe dehydration (only water)
(Burns, Diabetes Insipidus)
Increased Blood volume, HTN
Potassium :
Potassium Total body potassium is 3500 meq 75% in skeletal muscle
It is the major Intracellular cation
Daily requirement
3-4 gm/day
Sources
Banana, Orange, Potato, beans, Liver etc.
Rich Source is Tender coconut water.
Slide 37:
Functions:
It maintains Intracellular Osmotic pressure
Involves in cardiac & skeletal muscle activities
Mainly K+ required in depolarization & contraction of Heart.
Involved proper transmission of Nerve Impulses
Pyruvate kinase needs K+
Involved in Biosynthesis of proteins
Slide 38:
Normal Serum Potassium
3.5 – 5 meq/L
(Cell contain 100 – 120 meq/L)
Excretion is through urine, during absorption of Na+ there is obligatory loss of K+
Aldosterone K+ excretion
Disorders :
Disorders Hypo kalemia
Serum K+ less than 3 meq/L
Cushing syndrome
Renal tubular acidosis
Tubular necrosis
Metabolic alkalosis
Diarrhea & vomiting
In Diabetic coma treatment with Insulin & Glucose
Diuretics
Muscle weakness
Tachycardia
Cardiac arrest
Hyperkalemia :
Hyperkalemia Addisons disease
Renal failure
Increased hemolysis
Tissue necrosis
Metabolic acidosis
Insulin deficiency
Depression of central Nervous system
Flacid paralysis
Bradycardia & Cardiac arrest
Chlorine :
Chlorine Intake, output & metabolism of Na+& cl- run in parallel
Daily requirement
5-10gm
Sources
table salt – Nacl
grains, leafy vegetables, eggs & Milk.
Excretion is through urine as sodium :
Excretion is through urine as sodium Functions
Regulates Acid Base balance, Osmotic pressure, fluid balance in relation with Na+ & k+
Cl- are necessary for HCL formation
Chloride shift
Salivary amylase is activated by chloride
Slide 43:
Normal serum level is 96-106 meq/L
CSF level is 125 meq/L
Disorders
Hyper chloremia
Dehydration
Cushings syndrome
Severe diarrhea
Respiratory acidosis
Renal tubular acidosis
Hypo Chloremia
Addisons disease
Respiratory alkalosis
Excessive vomiting
