anemia Flashcards
What is the reference range of haemoglobin for males?
women :
140-180 g/l
120-150
minkovski chauffard
altered membrane
spectrin and anchoryn
more spherical
normocytic
sickcle cell
aplastic
microcytic
iron deficiency
chronic bleeding
pregnancy
fetal hb vs normal
fetal has a higher affinity for o2
link between TIBC and iron
low levels of iron increase tibc as body tries to compensate for lack of iron by increasing transferrin
addison - bermer anemia
or pernicious anemai a type of megoblastic anemia
megobalstic anmeia signs
hunters glossitis
demyleination of b12
iron deficieny anemia symptoms
heart palpiatations brittle nails tired pale skin restless leg syndrome PICA
POIKOLCYOTISI
shape (sickle cell)
Anisocytosis
different sizes
Howell-Jolly bodies
small bodies of DNA
usually occur when the spleen is not workin (aspelinism)
find them in megoblastic anemias
find them in SEVERE hemoluytic anemia - sickle cells
tx for heridtary
folic acid supplementation (mild)
blood transfusions for anemia
and if severe splenctomy before the age of 5 is curative
whats the genetic pattern of minkowski
Autoosmal dominant
why do kids need to take folic acid for heridery spherocytosis
because active hemolysis consumes folate so can lead to megaloblastic
which types of anemias are an exmaple of megalobalstic
- pernicious
- too little folate in diet
- hemolytic anemias !
- chronic alcoholics
- meds like mehotreaxts (which is why you have to take folic acid with it )
- diseases that ffect abosrption like celiac dsiease
what is the pronlem with bigger RBC
they more fragile -
change of shape
whats coombs test fro
to test wheter its autoimmune anemia or not
what does the coombs test entail
The Coombs test uses antibodies against these autoantibodies to cross link and agglutinate the red cells
types of coombs + anemias
warm
cold
what is warm AIHA
CAUSES
IG G
SPLEEN - extravascular
more common than cold
female predilection
Idiopathic
Lymphoproliferative neoplasms (CLL and lymphoma)
Drugs including methyldopa
SLE
cold AIHA
CAUSES
IG M
INTRAVSCULAR
MORE SEVER
Idiopathic
Post-infectious haemolytic anaemias: occurring 2-3 weeks after infection (examples include EBV and mycoplasma)
cold AIHA
CAUSES
IG M
INTRAVSCULAR
MORE SEVER
Idiopathic
Post-infectious haemolytic anaemias: occurring 2-3 weeks after infection (examples include EBV and mycoplasma)
TX OF COLD
warm the patient
plasmapheresis
tx of warm
CS
if doesnt work splenectomy
warm diagnosis
will see spherocytes
cold diagnosis
agglutinATION
rouleaux formation
whats the cause of paroxsymasl…
it affects the hematopoietic stem cells in bone marrow
the PIGA gene
certain proteins which protect (piga ptotein) rbc from attack are gone to complement comes into play
whats important to remember about paroxysmal
ITS ACQUIRED AND COOMBS -
pathophys of PNH
PIGA gene has mutated which is the what the compelment use to recognise cell as self
because its faulty complement now attacs rbc - hemolysis
it varies due to the amount of stem cells that have the muatation if only a little calm, if loads CRISIS
RSK FACTOR FOR PNH
aplastic anemia and other bone marrow diseases
symptoms of pnh
hemolytic anemai
blood clots increased risk due to so much complement activation and dodgey plt
cramps
pancotopenia
hb in pee - early in the morning as the days go on in clears up
what kind of anemia is pnh
normochromic normoctic and intravscuar
what kind of anemia is pnh
normochromic normoctic and intravscuar
what’s the risk of pnh
it can transfomr to other disorders like leukemia, apalatic anemia( so both ways ) myelodysplasia
key diagnois of pnh
flow cytometery
cd 59 +cd55
tx for pnh
definiive - allogenic
eculizamab
coombs negative examples of hemolytic anemias
Microangiopathic haemolytic anaemia
Paroxysmal nocturnal haemoglobinuria
Physical lysis of red cells e.g. malaria
Haemolytic uraemic syndrome (E. coli 0157:H7)
Infectious causes DIC (such as fulminant meningococcemia)
What are the acquired causes of haemolytic anaemia?
Autoimmune
Drug induced
Microangiopathic
Infection
Autoimmune
Drug induced
Microangiopathic
Infection
triggers for G6PD
antimalarial drugs
stress
illness
fava beans
HENNA
which is the most common type of AIHA
WARM
WHAT TYPE OF ANMEIA IS AIHA
NORMOCYTIC
WHAT TYPE OF ANMEIA IS AIHA
NORMOCYTIC
IN WHICH CONDITIONS DO YOU SEE SPHEROCYTES
- mikowski
- warm AIHA
HOWEL JOLLY BODIES ARE ASSOCIATED WITH
HYposplenism
epi of g6pdh
mediterranean
african
