Chap 20 Flashcards
Intro to Hemolytic Anemias
Laboratory tests to assess hemolytic anemias?
RPI
> 2 (Reticulocytosis)
BMB
Erythroid Hyperplasia
M:E Ratio Decreased
Increased osmotic fragility
PB
Normochromic, Normocytic,
Polychromasia-Increased Retics
NRBCs, Spherocytes, Schistos, Poik
Tests for heme catabolism abnormal:
- Unconjugated/Conjugated Bilirubin
increased
- Haptoglobin decreased
- LDH
- Increased Urobilinogen
Clinical findings in Hemolytic Anemias?
Jaundice- B/c all cells lyse
Pallor
Fatigue
Cardiac Symptoms
Gallstones
Dark/Red Urine
Splenomegaly- B/c cells die here or store here.
Intravascular RBC destruction has increased?
Free Hgb, b/c Haptoglobin has been depleted.
Sites of Extravascular RBC destruction?
Spleen- Slightly damaged RBCs.
Liver- Severely damaged RBCs
BM- Mature precursors intrinsically abnormal.
The only intrinsic congenital defect is?
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Site of intrinsic defect hemolysis?
Extravascular
Extrinsic defect of RBC?
Antagonist in the cell’s environment causing injury to RBC. Usually acquired.
Site of Extrinsic RBC defect hemolysis?
Intra or Extravascular
2 tests that would indicate increased RBC destruction?
Free Hgb
Serum Bilirubin
3 tests that would indicate increased RBC production?
Increased Absolute Retic Count
Increasing MCV (compared to baseline)
Erythroid Hyperplasia
RBC Morph of Spherocytes in Hemolytic Anemias?
Hereditary spherocytosis, IgG-mediated immune hemolytic anemia, thermal injury to RBCs
RBC Morph of Elliptos in Hemolytic Anemias?
Hereditary elliptocytosis
RBC Morph of Acanthocytes in Hemolytic Disorders?
Abetalipoproteinemia, severe liver disease (spur cell anemia)
Burr Cells Morph in Hemolytic Anemias?
Pyruvate kinase deficiency, uremia
Schistos Morph in Hemolytic Anemias?
Microangiopathic hemolytic anemia, traumatic cardiac hemolytic anemia, IgM-mediated immune hemolytic anemia
