Anemia due to Hemolysis

Question 1

How many fold increase can bone marrow produce blood?

Answer 1

6-8 fold.

Question 2

Where does extravascular turnover occur?

Answer 2

Spleen

RBC–> Hb–> bilirubin–> liver–> poop

Question 3

What things could cause a RBC to be selected for turnover?

Answer 3

1. dec in enzyme activity
2. Oxidative injury.
3. Changes in calcium.

etc.

Question 4

Which has a higher rate of hemolysis, acute or chronic?

Answer 4

Acute

Question 5

Describe Intravascular hemolysis.

Answer 5

Hemoglobin is released into blood.
Tetramer dissociates and dimers bind to hepatoglobin-> liver.

May also be converted to methemoglobin and then taken to liver.

Question 6

What tests are relevant for anemia?

Answer 6

• Morphlogy
• Reticulocyte counts
• Bilirubin total

Question 7

What is the basic defect in Hereditary spherocytosis?

Answer 7

Loss of membrane-> microspherocyte–> entrapment in spleen

decreased MCV

Question 8

What are the 3 proteins involved in the plasma membrane defects in Hereditary spherocytosis?

Answer 8

• Spectrin
• Ankyrin
• Band 3

Question 9

When does aplastic crisis happen?

Answer 9

When people with Sickle cell (or other blood diseases) get sick, RBC production in the marrow stops. This causes a severe drop in hematocrit for the duration of the illness.

Question 10

How is 6GPD related to energy and antioxidants?

Answer 10

6GPD is necessary for the glycolytic pathway of energy creation. It also is necessary for NADPH production. Without NADPH, glutathione cant be produced and therefore antioxidation weakens.

Question 11

How does 6GDP lead to hemolysis? 5 steps

Answer 11

loss of 6GDP-> oxidation of hemoglobin->Globin attaches to membrane-> deformation of RBC and spleen trapping->hemolysis

Question 12

What happens with Autoimmune hemolytic anemia in cold areas of the body?

Answer 12

Cold:

• IgM binds RBC. (big guys tough out the cold)
• Activate compliment
• Intravascular hemolysis. (You go Inside when its cold)
• Low affinity to RBC

Question 13

What happens with Autoimmune hemolytic anemia in warm areas of the body?

Answer 13

Warm:

• IgG binds
• Partial compliment activation
• Extravascular hemolysis
• High affinity to RBC membrane

Question 14

Which type of test tests for RBC antibodies in the serum?

Answer 14

Indirect Coombs test

Question 15

After splenectomy, patients are at high risk for ___________

Answer 15

Sepsis.