Autoimmune hemolytic anemias Flashcards

1
Q

Allo-immune
Auto-Immune
Drug induced

A

allo immune- outside stim
Auto immune- Attacking self
Drug induced - consequence of treatment

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2
Q

Immune anemias cause the destruction of…

A

rbcs and metabolism of products of destruction

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3
Q

Alloimmune causes

A

HTR, HDN

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4
Q

Autoimmune causes
c,p,w

A

CAS, PCH, WAIHA

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5
Q

Drug induced
dependent?
a?
d?

A

hapten dependent, auto, drug dependent

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6
Q

IgM
messes with?
what binds?

A

messes w reverse type (at room temp)

ABO binds compliment

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7
Q

Anemia classification

A

Class, compliment, strength, immune activation, titer….etc

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8
Q

First differentiating factor in autoimmune hem anemias

A

warm vs cold

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9
Q

Warm anemias overview
temp?
what may bind?
DAT rxn?

A?
extra?

Frequently?

Symptoms?
more in?

A

> 32 degrees
IgG may bind

DAT: IgG+ C3+/-

AHG
Extravascular

Frequently Rh

exhausted/anemic

more in the summer

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10
Q

Cold anemias overview
temp?
what class?
rxn?
spin?
hemolysis?

frequently?
extremities?

more in?

A

<30 degrees
IgM binds compliment
IgG - C3+
IS
Intra/extra

Frequently I or P

purple extremities

more in winter

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11
Q

Cold Rxn Antibodies
Benign
common?
low?
enhanced with?
ig class?
Anti?

A

most common
low titer
enhanced with alb/enzymes
IgM

Anti-I, IH or i

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12
Q

Cold rxn Antibodies
Pathogenic
common?
high?
enhanced with?
class?
Anti?

A

not common
high titer >1000
enhanced with alb/enzymes
IgM

Anti-I, P or M

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13
Q

Benign cold agglutinins

Anti-I
Anti- i
Anti- IH

A

Anti- I : doesnt react with cord rbcs

Anti- i: doesnt react w/ adult rbc

Anti-IH: doesnt react w/ AI, B or AB rbcs

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14
Q

Precursors
to developing….

A

to developing other autooimmune disorders like lupus, titer 0 cells <65

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15
Q

T/F pre-warm IS crossmatch and reverse type

A

ture

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16
Q

Patho cold agglutinins
CHD
chronic
symptoms?
ages?

AB?
wide range?
titer?
cells?

may have to do?

A

chronic hem anemia, purple, reynaurds disease
adults

Ab: Anti-I wide range thermal IgM
titer >1000 O cells

may have to do 60 min settling techniques for neg results

17
Q

PCH

A

after a virus, transient, children, Donthanlandstiener
IgG

specificity to Anti-P

18
Q

Warm autoab

extreme? no previous?
prefrerence? ig?

AVOID?

prevents? find a way?

A

extreme anemia, usally no previous transfusion

Rh preference, IgG may not fix compliment

AVOID TRANSFUSIONS

Prevent ID of allo-ab becausse they react with everything, find a way to remove auto ab to ID the ALLO

19
Q

Best ways to remove autoab to ID allo ab

A

AUTOABSORPTION BEST
allo abosroption - ref lab
Saline and cells/molecular

20
Q

Drug induced ab
looks like?
stop?
very fast?
hemolysis characterized by?

A

look like warm auto
stop taking drug
very fast hemolysis sometimes death

hemolysis characterized by tea like plasma color

21
Q

Drug-absorption
drug attaches?
no?

Drugs? (c/s/p)

A

drug attaches to rbc membrane
ab directed to drug causes destruction of rbc
IgG no compliment

CEFOTETAN
STREPTOMYCIN
PENICILLIAN

22
Q

Drug absorption detection
DAT
E
Hem?

A

DAT: IgG + C3-
eluate: neg
Hemolysis: yes

23
Q

Immune complex
forms ab to?

drugs? q/p

DAT?
Eluate?
Hem location?

A

forms ab to drug

QUINDINE/PHENACETIN

DAT: IgG +/= C3+
eluate: neg
Hem: yes intra

24
Q

Membrane modification
non?
Drug?

DAT?
E?
Hemolysis?

A

non immune process
CEPHALOSPORIN

IgG+ C3+
E: neg
Hem: no

25
Q

Drug Independent
autoab forms?
Drug? (a)

DAT?
E?
Hem?

A

autoab forms after 6 mos
ALPHA METHYLADOPA

IgG+ C3+/=
Elut: pos
Hem: yes

26
Q

Chemo Drug
attaches to?
Drug name? (D)

DAT rxn?
what blood is given to all pts?

Dtt ?

A

attaches to CD38

DARZALEX-UMAB

weak pos DAT

Big K- blood to all pts

DTT removes ag

27
Q

Treatment of cold anemias
skip?

A

blood warmer, skip IS

28
Q

Treatment of Warm anemias
DONT TRUST?
transfer only?

A

dont trust sero presentation
transfer only to support cardiovasc funct

29
Q

Treatment of drug anemias
tras…
p

A

transfusion reccomended in most cases, plasma exchange

30
Q

Which DAT result are consistend with CAD

A

Poly 3+
IgG 0
C3D 3+