Haematology 4 - Haemolytic Anaemia

Question 1

inherited haemolytic anaemia x 4

Answer 1

hereditary sphero/elliptocytosis
thalassaemia
sickle cell anaemia
G6PD deficiency

Question 2

5 acquired haemolytic anaemias

Answer 2

autoimmune 
transfusion reaction
microangiopathic
prosthetic valve
paroxysmal nocturnal Hburia

Question 3

3 key features of haemolysis

Answer 3

anaemia
splenomegaly
jaundice

Question 4

3 investigations for haemolytic anaemia

Answer 4

FBC
blood film - shistocytes
Direct Coombs test - positive if autoimmune

Question 5

inherited spherocytosis / elliptocytosis

Answer 5

auto dominant
fragile RBCs

jaundice, gallstones, SM, aplastic crisis with parvo

spherocytes, reticulocytes

folate supplement
splenectomy

Question 6

G6PD deficiency

Answer 6

it’s an enzyme deficiency
X linked recessive

triggered by eating broad beans, antimalarials (+others), infection

neonatal jaundice + Heinz bodies

Question 7

autoimmune haemolytic anaemia

Answer 7

antibodies vs RBCs

warm type more common + unknown trigger

cold type usually secondary to blood cancers, SLE or viruses

Question 8

managing autoimmune HA

Answer 8

transfusions
pred
rituximab
splenectomy

Question 9

paroxysmal noctural Hburia

Answer 9

rare
mutation leads to lack of complement inhibition

red urine in the morning
clots
smooth muscle dystonia - erectile dysfunction

eculizumab
BM transplant

Question 10

microangiopathic haemolytic anaemia causes x5

Answer 10

cancer
haemolytic uraemic syndrome
DIC
TTP

haemolysis occurs in the small blood vessels