General - Ch. 14 Flashcards
MCV
Average RBC volume
MCH
Average Hgb content
MCHC
Weight % due to Hgb
RDW
Average weight/size of RBCs
- Mechanical injury
- Complement fixation
- Intracellular parasites
- Toxic injury
Intravascular hemolysis causes
- Mechanical valves
- Thrombotic narrowing of microvasculature
- Repetitive trauma
Causes of mechanical injury to RBCs (intravascular hemolysis)
Major intracellular parasite in RBCs, causing intravascular hemolysis
Malaria
Clostridial sepsis
Major cause of toxic injury to RBCs, causing intravascular hemolysis
Red-brown urine in intravascular hemolytic anemia…cause?
Methemoglobin (after haptoglobin is depleted)
Jaundice in hemolytic anemia
Hgb-haptoglobin complexes metabolized to unconjugated bilirubin
What is commonly seen in the kidney in intravascular hemolytic anemia?
Hemosiderosis (iron deposition in tubules)
Extravascular hemolytic anemia is due to what?
Causing what?
Decreased deformability of the RBC membrane
Splenic sequestration, macrophage phagocytosis
Profoundly chronic anemia can cause what changes in other organs?
Fatty change in liver, heart, kidney, CNS
Hypo-micro anemia usually due to deficit in ____, generally
Hgb synthesis
Macrocytic anemia usually due to deficit in ____, generally
Maturation of erythroid precursors
Reticulocytosis implies that ____ and ____
The BM is functional, and RBCs are being lost
Conjugated hyperbilirubinemia…rule out what?
Hemolytic anemia (always unconjugated)
- Viral hepatitis
- Pneumonia
- Typhoid fever
Infectious causes of oxidant stress in G6PD deficiency
- Antimalarials (primaquine, chloroquine)
- Sulfonamides
- Nitrofurantoins
Drug causes of oxidant stress in G6PD deficiency
Fava beans
Food cause of oxidant stress in G6PD deficiency
Cross-linked sulfhydryl groups on damaged globin chains that become denatured and form membrane-bound precipitates
Cause what?
Pathology appearance?
Disease?
Heinz bodies
Membrane damage –> intravascular or extravascular hemolysis
Dark inclusions in RBCs on crystal violet, w/ BITE CELLS and SPHEROCYTES
G6PD deficiency
- Aplastic crises
- Hemolytic crises
Organisms for each?
Hereditary spherocytosis
Aplastic = parvovirus Hemolytic = EBV (mononucleosis)
Sickle cell disease is what?
Mutation in beta-globin gene, causing polymerization of hemoglobin w/in RBCs in certain physiologic conditions, leading to hemolysis and anemia
2 reasons for malaria prevention in sickle cell
- The parasite consumes oxygen and decreases pH, causing sickling
- Impaired formation of PfEMP-1
Protection from malaria
- G6PD deficiency
- Sickle cell disease
- Thalassemias
- Chronic hemolysis
- Microvascular occlusions
- Tissue damage
Sickle cell disease - major pathologic manifestations
HbSC sickle cell prognosis/symptoms compared to normal sickle cell
Better/milder than normal sickle cell
Left off on p. 636
a
