Anemias

Question 1

Spherocytosis

Answer 1

Defect in ankyrin
Hyperchromic, extravascular, hemolysis

Question 2

Elliptocytosis

Answer 2

Defect in spectrin
Protective against malaria

Question 3

PK deficiency

Answer 3

Decreased ATP, increased 2,3BPG, rigid RBC
Normocytic normochromic

Question 4

G6PD deficiency

Answer 4

Decreased NADPH, decreased GSSG and increased ROS - damage

Heinz bodies, episodic

Question 5

PNH

Answer 5

Defect in PIGA/GPI anchor/CD55&59

Question 6

March hemoglobinuria/foot strike

Answer 6

Trauma from running, small blood vessels

Question 7

WAIHA

Answer 7

IgG ran with Rh at 37 degrees
Extravascular
IgG+
Decreases platelet, microspherocytes

Question 8

CAD

Answer 8

Type of CAIHA
Can be extravascular or intravascular
C3 and IgM positive

Question 9

DAT/Coombs test

Answer 9

Anti IgG and anti C3 - immune mediated

Question 10

PCH

Answer 10

Kids with respirator infection, dark urine

Intravascular
C3+

Biphasic IgG activates complement in cold and dissociates in warm so only C3 positive

Question 11

Drug induced

Answer 11

Antibiotics - IgG - extravascular
Quinidine - C3+ - intravascular

Question 12

Iron deficiency anemia

Answer 12

Microcytic, normochromic

Decreased Fe, serum ferritin (less storage), % transferrin (not much iron to bind)
Increased TIBC (body trying to scavenge more)

Low hepcidin

Question 13

Hepcidin

Answer 13

Inhibits iron absorption

Hi - no iron absorbed
Lo - iron absorbed

Question 14

Thalessemia

Answer 14

Microcytic, hypochromic

Decreased RBC, Hb, erythropoiesis

Decreased ferritin

Question 15

Sideroblastic anemia

Answer 15

Hereditary

No heme, but excess free iron, ring sideroblasts

Increased iron, decreased TIBC, increased % transferrin, increased ferritin

Question 16

Anemia of chronic disease

Answer 16

Mild hypochromic, microcytic

Decreased Fe, TIBC, % transferrin, increased ferritin

Presence of IL-1 & TNF can decrease EPO

Question 17

Megaloblastic anemia

Answer 17

Macrocytic anemia
Larger, oval, hyperhsegmented nucleus
Decreased reticulocytes
Can be caused by B12 or B9 deficiency

Question 18

B12 deficiency

Answer 18

B12 from diet absorbed in ileum
Build up of MMA and homocysteine

Question 19

Pernicious anemia

Answer 19

Autoimmune attack of IF, decreased B12

Question 20

B9 deficiency

Answer 20

B9 absorbed in SI
Needed for purine and pyrimidines
Build out of homocysteine

Question 21

Sickle cell anemia

Answer 21

Normocytic, bite cells

Vasoocclusion pain crisis, ischemia, acute chest syndrome, splenic sequestration

Treat with hydroxyurea (increases HbF)

Question 22

Alpha thalassemia

Answer 22

Silent, trait/mild, disease , hydrous fetalis

Causes HbH = B tetramers

Some HbBarts = Y tetramers - hemolytic

Question 23

Beta thalassemia

Answer 23

Carrier - intermediare - major = Cooley’s, transfusion dependent

Symptomatic at 3 months when HbF drops

Increased EPO - bone deformation