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nbme21/Block 3/Question#47 (27.0 difficulty score)
A 48-year-old man comes to the physician ...
Increased intestinal iron absorptionπŸ”,πŸ“Ί
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 +8 
submitted by chillqd(39),
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ehT mteS si idsenbgirc tsaimor,cmhooesh dehacraizcrte by onamlabr irno sgsinne dna canieerds tlteasiinn toranbsipo. Tsih senciasre on,rI iringnsace ierr.ftni In o,enssrep CTBI si erec,ddesa whhci eeincrsas rearsfnintr asnaiorutt sa teehr is ssle ciingutcrla rceirra mee.ullcos

With sxeces oirn in teh obo,ld ti will lcumaetcua in uistess ngndiicul hte lvi,er ik,ns r.acnsepa elqSee au udiclne eiltdda aopmoaytdcyi,hr yap,dnoohmisg sbeat,edi phryrhtaaot 22/ cilaumc eotyrohphsppa ,sieidopnto dn epraatlulHcelo rnicoaCma

hello  I think you made one slight mistake. TIBC = total iron binding capacity. It is synonymous with "transferrin saturation". This patient has increased transferrin saturation aka increased TIBC. The transferrin molecules are saturated -- it is incorrect to say "as transferrin saturation increases, there is less circulating carrier molecules." It is more correct to say that the amount of free (unbound) transferrin is decreased. +1  
hpsbwz  @hello Transferrin saturation and TIBC are not synonymous. Transferrin is calculated using total body iron / TIBC. While the serum iron level continues to increase, the transferrin level decreases. Thus, the amount of transferrin available to bind iron (TIBC) decreases and the amount of transferrin saturated with iron (i.e., percent transferrin saturation) increases. +10  
mangotango  Just to clear up definitions: Total Iron Binding Capacity (TIBC) = measure of trasnferrin molecules in the blood (bound by Fe or not). % Saturation = percentage of transferrin molecules that are bound by Fe (normally 33%) // Pathoma pg. 42 +  



 +3 
submitted by chandlerbas(100),
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sethre os umch iorn ni het odlob that ti hsa ot og .oeermhwse it geos tion eth elcls ni hte obyd isendce(ra fer)inrit dan it bidsn ot eht ceriarr osnprartt pornite f.netsrnrria seaceub ti bnisd to lla hte rristfaernn uoy heva owl refe nefrtrinra.s btu ruoy bydo esnses eht low erfe nfiserrtnra nda sgeo ok" all my rinrnsrtafe rae lful of onir I essug im ko i ntdo ndee manryoe oi"nr so ti ospst kminga sir.earrnnft os lwo trianenfsrr or ltato nroi bgiidnn catyaicp ermme(erb htsi si sjut a fanyc ayw fo snigay it stnedo want .rreri.tn.af).sn now esfnn%triarr tas si sujt hmta (i ehta ht)am ist ikle :isth BrC/,TIoin ew yadealr otg hgih noir so aueortrmn si hgh,i dan wol odmoneatirn bc ilke i siad CTIB si owl so aeolvlr ruoy ernfrtr%isan nrtutaiaos is yrev ghhi. sthi is eht tbse tidrocina orf orshihsommceaot




 +2 
submitted by dr.xx(153),
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rarehiedyt .sorcaotomishehm

EHF si tmatdeu ;&=gt eth tnieiesstn uytlperpael petrenirt a nsgrot earrrnifnts gnalsi sa fi eht body wree etindiefc ni ori.n sTih adsel to imalxma inor obatpirosn orfm tienedsg dsoof dan nori ooaerdvl ni eht sesistu.

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lovebug  Autosomal recessive. C282Y mutation > H63D mutation on HFE gene, located on chromosome 6;associated with HLA-A3 [FA2019, PG.389] +