Anaemia Tutorial Flashcards
What are the four mechanisms of anaemia?
- Reduced production of red cells/haemoglobin in the bone marrow
- Reduced survival of red cells in the circulation - haemolysis
- Loss of blood from the body
- Pooling of red cells in a very large spleen
What are microcytic cells usually?
hypochromic
What are normocytic cells usually?
normochromic
What are macrocytic cells usually?
normochromic
What are round cells without usually central pallor?
spherocytes
What hereditary spherocytosis?
an inherited defect in the red cell membrane
Why would her bone marrow producing more of these young red cells than normal in hereditary spherocytosis?
a
What does the term haemolysis and haemolytic anemia mean?
-Haemolytic: increased destruction with shortened RBC survival
How do you treat hereditary spherocytsosis?
-Folic acid (because of increased need)
-Splenectomy (if severe) to increase red cell life span)
Why would gallstones form from hereditary spherocytsosis?
because of the increased breakdown of haemoglobin to bilirubin
What is the laboratory evidence of haemolysis?
- LDH raised
- Unconjugated hyperbilirubinemia
- Reduced haptoglobins
What is the bone marrow response to haemolysis?
reticulocytosis
What are some non immune environmental factors which can damage RBCs?
- Microangiopathic
- Haemolytic uraemic syndrome
- Malaria
- Snake venom
- Drugs
What are some immune mediated environmental factors which can damage RBCs?
- Auto-immune
2. Allo immune (post blood transfusion)
What is a direct antiglobulin test (DAT)
- Antibodies bonding to antigen on the erythrocyte membrane in a patient who has developed an autoantibody
