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nbme24/Block 3/Question#15 (36.8 difficulty score)
A 17-year-old girl has significant blood loss ...
Ξ΄-AminolevulinateπŸ”
tags: heme heme_synthesis biochem 

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 +14 
submitted by neonem(570),
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the odby rsndeops ot obodl olss yb e.spsoieihamto siTh roccsu yb urleggnpitau tfrsnrreian na( orin rrpoatnsret in eth dlo)bo, torrniiheopyet npdtoircou (a hnmoreo edma ycexeuslvil in eht reanl ubrpuielart tetinisrliat cl)se,l adn mehe yisensht.s srFti etsp of mehe nisssyteh wsa ltcluaya delldau ot ni nahreot itnqesou no shti :etst dnnosnoteaic of glniecy and inyclcsu oCA iton lelme-loatu.ndneiatavi sTih si ii-tigtaenlrm estp of emhe eitsnss.hy

wowo  FA2019 p417 +2  



 +11 
submitted by urachus(16),
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nto PEO bc ist' kangsi awths' dame rfom het oneb ar.mwor OPE si rmfo kydeni

lilyo  Thanks, I was wondering why EPO was not correct. So EPO synthesis would be stimulated in case of blood loss? its just wrong becase they ask specifically what is going to be produced in the bone marrow? +2  
suckitnbme  @lilyo yes because it's specifically asking what the bone marrow is synthesizing. EPO would also be upregulated but this happens in the kidneys. +3  



 +2 
submitted by theunscrambler(3),

If anyone was wondering about Ferritin as I was.

Iron level functions as a regulator of ferritin transcription. "when iron levels are low, ferritin synthesis is decreased; conversely, when iron levels are high, ferritin synthesis increases."

If iron is low as it would be in significant blood loss, the body would want to mobilize iron to produce heme and not sequester it. This results in decreased ferritin production and increased transferrin.

https://ashpublications.org/blood/article/99/10/3505/106937/Regulation-of-ferritin-genes-and-protein




 +1 
submitted by syoung07(30),

EPO made in kidney, EPO tells the bone marrow to ramp up erythropoiesis.