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Haematology Week 1 2018/19 > 7: Haemolysis > Flashcards

7: Haemolysis Flashcards

1
Q

What are the products of red blood cell breakdown?

A

Iron

Bilirubin

Amino acids

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2
Q

How long does a red blood cell normally last in the circulation?

A

120 days

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3
Q

What is haemolysis?

A

Premature RBC destruction

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4
Q

What shape are red blood cells?

A

Biconcave

Greater surface area, allows them to squeeze through bone marrow and high pressure circulation

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5
Q

Which organelles do red blood cells lack?

A

Nucleus

Mitochondria

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6
Q

What process compensates for haemolysis?

A

Erythropoiesis

i.e RBC production

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7
Q

In compensated haemolysis, ___ concentration is maintained within normal limits.

A

Hb

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8
Q

In ___ haemolysis, Hb concentration decreases.

A

decompensated haemolysis

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9
Q

What change occurs in the bone marrow secondary to haemolysis?

A

Hyperplasia

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10
Q

What clinical sign can be seen in patients with haemolysis?

A

Jaundice

Increased levels of bilirubin

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11
Q

Which kind of cells are seen in increased numbers in the bone marrow in response to anaemia?

A

Reticulocytes

Reticulocytosis

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12
Q

Why do reticulocytes stain blue-grey (polychromatic) on a blood film?

A

They still have RNA

Producing cells of different colours, i.e a polychromasia

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13
Q

Is reticulocytosis only seen in haemolytic anaemia?

A

No

Bone marrow response to anaemia - bleeding, iron deficiency etc.

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14
Q

How are reticulocytes described when stained on a blood film?

A

Polychromatic

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15
Q

What is erythroid hyperplasia?

A

Increase in bone marrow cell number in response to EPO

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16
Q

In which organs can red blood cells be broken down?

A

Spleen

Liver

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17
Q

Apart from the spleen and liver, where can red blood cells be broken down?

A

Circulation

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18
Q

(Intravascular / Extravascular) haemolysis is more common.

A

Extravascular haemolysis more common

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19
Q

What happens to the organs in which haemolysis occurs?

A

Increase in size

so producing splenomegaly, hepatomegaly

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20
Q

What are the RBC products released in extravascular haemolysis?

A

Normal products

i.e bilirubin, iron and amino acids

21
Q

Intravascular haemolysis is a (normal / abnormal) process.

A

abnormal

so the products released are abnormal as well and you get symptoms like pink urine

22
Q

Patients given which type of blood transfusion can develop haemolysis?

A

Incorrect group

23
Q

Which enzyme deficiency, increasing oxidative stress exerted on red blood cells, can cause haemolytic anaemia?

A

G6PD deficiency

24
Q

Which infection can cause haemolytic anaemia?

A

Malaria

25
Q

What are the two types of haemolytic anaemia?

A

Intravascular

Extravascular

26
Q

What is the most common inherited disorder causing haemolytic anaemia in the UK?

A

Hereditary spherocytosis

27
Q

Haemolytic anaemia is commonly caused by ___ disease.

A

autoimmune disease

28
Q

Which connective tissue disease can cause autoimmune haemolysis?

A

SLE

29
Q

Autoimmune haemolysis is caused by either ___ or ___ autoantibodies.

A

warm or cold

30
Q

What type of antibody are warm AH antibodies?

A

IgG

more common than cold

31
Q

Which test is used to diagnose warm autoimmune haemolysis?

A

Coombs test

Should be +ve

32
Q

What type of hypersensitivity reaction is a blood transfusion reaction?

A

Type II

Antibody-mediated

33
Q

What causes most haemolytic disease in newborns?

A

Rhesus reaction

RhD- mother receives RhD+ blood from baby (haemorrhage, birth etc.), autoantibody response which then goes back to baby causing haemolysis

Avoid with anti-D injections

34
Q

Which specific GI infection may cause acquired haemolytic anaemia?

A

E. coli 0157

35
Q

Why can implanted heart valves cause haemolysis?

A

Mechanical damage to RBCs

i.e cells bouncing off metal

36
Q

Problems with which part of a red blood cell can cause haemolysis?

A

Cell membrane

37
Q

What is the most common inherited condition causing haemolytic anaemia?

What cell structure does it affect?

A

Hereditary spherocytosis

Cell membrane

38
Q

Which molecule keeps iron in its ferrous (Fe2+) form in red blood cells?

A

NADPH

39
Q

Which cause of increased oxidative stress can cause haemolysis?

A

G6PD deficiency

40
Q

Which derm condition is associated with Coeliac disease?

A

Dermatitis herpetiformis

41
Q

Which treatment for dermatitis herpetiformis is associated with haemolysis?

A

Oral dapsone

42
Q

Which disease affecting the structure of haemoglobin can cause haemolysis?

A

Sickle cell disease

43
Q

What haematological disorder is frontal bossing associated with?

A

Beta thalassaemia

44
Q

Blood transfusion reactions are a cause of (extravascular / intravascular) haemolysis.

A

intravascular

45
Q

What are the signs and symptoms of hereditary spherocytosis?

A

Intermittent jaundice

Gallstones

Splenomegaly > Splenectomy at young age

46
Q

Malaria causes (extravascular / intravascular) haemolysis.

A

intravascular haemolysis

47
Q

What is HbH disease?

What is HbH?

A

Form of alpha thalassaemia (3 out of 4 genes deleted)

Crap form of Hb with 4 beta chains

Flare ups with stress, drugs

48
Q

What is the definition of haemolysis?

A

PREMATURE RED CELL DESTRUCTION

Haematology Week 1 2018/19 (9 decks)

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