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Hematology > Anemia and Hemolytic Anemia (Exam 2) > Flashcards

Anemia and Hemolytic Anemia (Exam 2) Flashcards

1
Q

What is the definition of anemia?

A

increase RBC destruction | decrease RBC production | excessive blood loss | = all contribute to reduced O2 delivery to tissues (mild asymptomatic to severe symptomatic)

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2
Q

What are the 5 causes of anemia?

A

impaired RBC production | fast RBC destruction | excessive blood loss | hemodilution | combined mechanism

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3
Q

What are the 4 differential diagnoses of anemia due to impaired RBC production?

A

aplastic anemia | Fe-deficiency anemia | pernicious anemia | sickle cell anemia

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4
Q

What are the 4 differential diagnoses of anemia due to accelerated RBC destruction?

A

congenital spherocytic anemia (inherited) | pernicious anemia | sickle cell anemia | erythroblastosis fetalis

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5
Q

What are the 2 differential diagnoses of anemia due to accelerated RBC destruction?

A

acute and chronic blood loss &raquo_space;> normochromic and normocytic anemia

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6
Q

What is erythroblastosis fetalis?

A

Rh-hr incompatibility between mother and fetus | mother’s immune system begins to attack fetus RBCs | will be difficult for subsequent children to survive gestation

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7
Q

What is the differential diagnosis of anemia due to hemodilution?

A

renal disease - body retains water = decrease urine excretion

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8
Q

What are the 2 differential diagnoses of anemia due to combined mechanism?

A

pernicious anemia and sickle cell anemia = impaired RBC production + accelerated destruction

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9
Q

What are the symptoms of anemia based on differing (2-8g) Hb levels?

A

8g = pale | 6g = dizzy | 4g = nausea | 2g = coma

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10
Q

What are 4 causes of anemia secondary to BM injury?

A

ionizing radiation targets nucleus | chemicals | infection in BM | malignancy in BM

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11
Q

What are the 7 differential diagnoses of hypochromic microcytic anemia? Which is the most common?

A

lead poisoning | thalassemia | pyridoxine deficiency | sideroblastic anemia | Fe-def anemia (most common) | chronic inflammation (macrogphage doesn’t release) | porphyria

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12
Q

What is the urine color from patients with acute porphyria? What is this due to?

A

burgundy wine color | patient does not have isomerase present in heme synthesis, only deaminase = produces only uroporphyrinogen I not III

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13
Q

What is porphyria? What does it result in?

A

the intermediate products within heme synthesis that cannot be used and will be excreted out into plasma; can include enzyme dysfunction | less Hb production = hypochromic microcytic RBCs

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14
Q

How can one diagnose porphyria?

A

urine = abnormal color, yellowish | fluorescents under UV

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15
Q

What are 2 causes of porphyria?

A

certain medications | lead poisoning

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16
Q

What is transferrin deficiency caused by?

A

individual producing Abs against transferrin

17
Q

How much of the 1% old RBCs are lysed inside macrophages? (daily) And how much are lysed outside macrophages?

A

90% | 10%

18
Q

What is hemolytic anemia due to?

A

anemia due to RBC lysis in vessels | bacterial infections and certain meds can contribute to this anemia

19
Q

How common is hemolytic anemia?

A

very common

20
Q

What is the difference between extravascular hemolysis and intravascular hemolysis?

A

extravascular = outside blood stream (ie: hematomas) | intravascular = inside blood stream (more common)

21
Q

If the individual has a haptoglobin level of 200mg/dl, would you expect this individual to have a lot of abnormal intravascular hemolysis?

A

No | there is enough haptoglobin to neutralize Hb

22
Q

What does a haptoglobin value of 0 or a low value mean?

A

a lot of hemolysis outside of macrophages

23
Q

Where does the excess Hb go into when it cannot be picked up by tubular cells of the kidney?

A

goes into urine

24
Q

Would it be considered extensive hemolysis of RBC outside of macrophages when urine shows high levels of Hb? How can you confirm this hypothesis?

A

yes = Hb seen in urine (hemoglobinuria) | observe a low haptoglobin level

25
Q

What is intrinsic defect factor of hemolytic anemia?

A

defect in the RBC itself

26
Q

What are 2 examples of intrinsic defect in hemolytic anemia?

A

congenital spherocytic anemia and elliptocytosis

27
Q

What are the 2 diagnosis for hemolytic anemia due to intrinsic defect?

A

low haptoglobin | poikilocytosis (cell membrane not stable = easily lyse)

28
Q

What is the treatment for hemolytic anemia due to intrinsic defect?

A

remove spleen = remove lyses

29
Q

What does extracorpuscular mean?

A

outside factors

30
Q

What are the 3 extracorpuscular factors causing hemolytic anemia?

A

autoimmune anemia | bacterial and parasitic infections | certain medications

31
Q

What is an example of an autoimmune disease that causes hemolytic anemia?

A

lupus | low haptoglobin and patient looks pale

32
Q

How can bacterial and parasitic infections cause hemolytic anemia?

A

can produce toxins that lyse RBC

Hematology (20 decks)

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