Question: (5 Points) Individuals With Hemochromatosis Are Often Discouraged From Consuming Ascorbic-acid-containing Foods With Meals Containing Iron. Why? (15 Points) Case Presentation: Dolores Welborn Is A 28-year-old Attorney Living In Portland, Oregon. Dolores Is In The Second Trimester Of Pregnancy With Her First Child, And Though Her Pregnancy Had Been …

Question: (5 Points) Individuals With Hemochromatosis Are Often Discouraged From Consuming Ascorbic-acid-containing Foods With Meals Containing Iron. Why? (15 Points) Case Presentation: Dolores Welborn Is A 28-year-old Attorney Living In Portland, Oregon. Dolores Is In The Second Trimester Of Pregnancy With Her First Child, And Though Her Pregnancy Had Been …

  1. (5 points) Individuals with hemochromatosisare often discouraged from consuming ascorbic-acid-containing foodswith meals containing iron. Why?
  1. (15 points) Case Presentation: Dolores Welbornis a 28-year-old attorney living in Portland, Oregon. Dolores is inthe second trimester of pregnancy with her first child, and thoughher pregnancy had been progressing normally, recently she hasnoticed that she tires very easily and is short of breath from eventhe slightest exertion. She also has experienced periods oflight-headedness, though not to the point of fainting. Otherchanges she has noticed are cramping in her legs, a desire tocrunch on ice, and the fact that her tongue is sore. She doubtsthat all of these symptoms are related to one another, but she isconcerned, and she makes an appointment to see her physician. Uponexamining Dolores, her physician finds that she has tachycardia,pale gums and nail beds, and her tongue is swollen. Given herhistory and the findings on her physical exam, the physiciansuspects that Dolores is anemic and orders a sample of her bloodfor examination. The results are shown in Table 1. A diagnosis ofanemia due to iron deficiency is made and oral iron supplementsprescribed. Dolores’ symptoms are eliminated within a couple ofweeks and the remainder of her pregnancy progresses withoutdifficulty.

Questions: Describethe structure of a molecule of hemoglobin and explain the roleplayed by iron in the transport of oxygen. How is iron stored andtransported in the body? What is Iron Deficiency Anemia (IDA) andhow frequently does it occur? What are the most common causes ofIDA? Why are women more prone to IDA than men? What are the redblood cell indices, and what tests are diagnostic for IDA? How isIDA treated and prevented?

Table 1. Blood SampleResults

Red Blood CellCount     3.5 million/ mm3

Hemoglobin(Hb)            7g/dl

Hematocrit(Hct)            30%

SerumIron                      low

Mean Corpuscular Volume(MCV)         low

Mean Corpuscular Hb Concentration(MCHC)             low

Total Iron Binding Capacity in theBlood(TIBC)           high