Anaemia MedEd part 2 Flashcards
Young child, anaemic
Thalassemia
HUS
ALL
Microangiopathic haemolytic anaemia pathophysiology and what is seen on blood film
Shearing of red blood cells in small vessels, causing schicostocytes and microthombi formation
Three types of MAHA
HUS
DIC
TTP
Triad of HUS
- Haemolytic anaemia - aka jaundice and conjunctival pallor
- AKI/uremia
- Thrombocytopenia
Which e-coli is associated with HUS? What toxin does it produce?
EHEC O157:H7
Shiga toxin
Symptoms of Ecoli + HUS
Abdominal pain
Diarrhoea
DIC features
Massive clotting everywhere, leading to depletion of clotting factors and thus bleeding
Bleeding
- petechiae, haematuria, ecchymoses
Clotting features
- prolonged APTT and PT
Haemolytic features
- jaundice, conjunctival pallor
DIC blood results
Low platelets
Low fibrinogen
High d dimer
High fibrin degradation productions
Causes of DIC
ITU Pancreatitis Cancer Sepsis Trauma ABO reaction Obstetric complications
Pathophysiology of TTP
Problem with enzyme that cleaves wVF (ADAMTS-13 enzyme), meaning you clot more
Pentad for TTP
ADAMTS-13:
Antiglobulin negative Decreased platelets AKI MAHA Temperature Swinging CNS signs
Which signs overlap between TTP and HUS?
Haemolytic anaemia
AKI
Low platelets
Which additional features of the triad does TTP have?
Fever
Neuro signs
Who commonly gets HUS?
Children under 5
Which test do you do if you want to find out whether the haemolytic anaemia is autoimmune or not?
DAT/Coombs test
What are the different types of results of the Coombs test?
Depends on what temperature the agglutination happened
Warm agglutinins
Cold agglutinins
Which immunoglobulin is associated with warm agglutination?
IgG
g=great weather, warm
Which conditions have warm agglutination?
SLE
CLL (smear cells, nontender lymphadenopathy)
Which immunoglobulin is associated with cold agglutination?
IgM
Which antibodies are associated with IgM/conditions have cold agglutination?
Mycoplasma - atypical pneumonia
Mononucleosis - EBV
Name an infective cause of haemolytic anaemia
Malaria aka plasmodium falciparum
also called black water fever
Name a drug that might cause haemolytic anaemia
Dapsone - an anti-leprosy antibiotic
Name the acquired and congenital causes of haemolytic anaemia
ACQUIRED: Infection Drugs Autoimmune MAHA - HUS, TTP, DIC
CONGENITAL
G6PD
Hereditary spherocytosis
Haemolytic anaemias are typically normocytic or microcytic?
Normocytic
What is myelofibrosis?
Primary myelofibrosis = in response to a bone marrow malignancy
Overproliferation of fibroblasts aka cancer
Myelofibrosis buzz words / on blood film
Tear drop cells as rbc have to squeeze through fibrosis
BM aspirate findings for myelofibrosis
Dry tap
Symptoms of myelofibrosis
Massive splenomegaly (extramedullary haematopoesis) Weight loss
Risk factors for myelofibrosis + conditions which predispose
Radiation exposure
Elderly
Essential thrombocythaemia (overproduction of platelets) Polycythemia vera
Differentiate between haemochromatosis and sideroblastic anaemia
Both have high serum iron and ferritin, and low TIBC
However sideroblastic anaemia has:
- Pappenheimer bodies (iron deposition in rbc)
- Basophilic stippling
What is sideroblastic anaemia
Disorder of iron incooperation inside RBC due to x-linked genetic or acquired causes
What is myelodysplasia
Lots of immature cells that may develop into AML
Similar symptoms
