NBME 21 Answers ↦
sympathetikey
Got the right answer too, but man, that whole "1 month after starting therapy" almost threw me off.
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2019-06-12T22:57:47Z
fkstpashls
all I do is put the wrong answer when I'm between two. Fuck
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2019-12-23T16:10:58Z
cooldudeboy1
i like the way to remember acd but there is no bacterial etiology in Rheumatoid arthritis is there?
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2019-10-22T11:37:04Z
the_enigma28
The body recognises chronic inflammatory states as infections
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2019-11-12T16:31:25Z
fatboyslim
Ferritin is not the "iron delivery trucks", that's actually TRANSFERRIN (transfers iron to liver and bone marrow). Ferritin is the STORAGE form of iron in the liver and bone marrow. In anemia of chronic disease, there usually is an inflammatory process going (whether infectious, auto-immune [as in this case of Rheumatoid Arthritis], or cancer). During inflammation, the body releases IL-6, which releases hepcidin. Hepcidin downregulates ferroportin channels in the gut and on macrophages; therefore you absorb less iron from the GI and iron is trapped in macrophages (ferritin) and cannot be used for RBC production. All this causes INCREASED FERRITIN, decreased TIBC (if ferritin goes up, TIBC goes down and vice versa), and decreased serum iron levels and TIBC saturation (the bone marrow will suck up all the serum iron to make RBCs because it cannot make use of the iron stored as ferritin).
+7
2020-01-04T03:42:35Z
submitted by dr.xx(129), 2019-06-12T09:42:47Z
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