3.21 WHITE Hemolytic Anemia

Question 1

Two Main Type of Hemolytic Anemia

Answer 1

Intrinsic vs Extrensive Hemolysis

-Intrinsic are usually alway hereditary execept: paroxysmal noctural…

Question 2

Main types of Intrinsic Hemolysis

Answer 2

Membrane, Metabolic, Hemoglobin syn

Question 3

Extrinsic Hemolysis

Answer 3

Microangiopathic conditions, Immune, infectious and hypersplenism (usually secondary)

Question 4

Common Features

Answer 4

Jaundice: lysing RBC releases Hgb which gets metabolized to bilirubin down line
Kidney Failure: Iron deposition into the kidney

Question 5

MCV

Answer 5

With be falsy elevated b/c of high reticulocyte count (compensation) especially with membrane

• HCT/RBC, Mean RBC Volume
• Have to adjust
• RDW: measure of variation in size will also be elevated

Question 6

MCHC

Answer 6

Mean Cell Hgb
Will be high, esp with sperocytes
Think:
Cell volume is decrease b/c of loss of membrane but Hgb remains same so cell is getting denser while retaining same amount of Hgb

Question 7

Indicators of Hemolysis

Answer 7

• Peripheral Smear
• Retic Count high (not always)
• Bilirubin high
• LDH** should be high
• Plasma and Urine Hgb should be high
• Urine hemosiderin (from Hgb breakdown) high
• Haptoglobin (binds plasma Hgb) should be low