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Y3 Haematology > Haemolysis > Flashcards

Haemolysis Flashcards

1
Q

what is haemolysis?

A

the premature destruction of red cells

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2
Q

what is compensated haemolysis?

A

increased red cell destruction that is compensated for by increased red cell producction

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3
Q

what happens to the Hb level in compensated haemolysis?

A

it is maintained so the patient won’t become anaemic

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4
Q

what is another name for haemolytic anaemia?

A

decompensated haemolysis

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5
Q

what is haemolytic anaemia?

A

increased rate of red cell destruction that exceeds the bone marrows capacity for red cell production

causes a fall in Hb

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6
Q

what are the two main consequences of haemolysis?

A

erythroid hyperplasia

excess RBC breakdown products

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7
Q

what is erythroid hyperplasia?

A

increased bone marrow RBC production

the appropriate response to reduced RBC levels

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8
Q

what is the appropriate bone marrow response to haemolysis and how is this achieved?

A

increase RBC production

via reticulocytosis and erythroid hyperplasia

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9
Q

what are the two types of haemolysis based on where the haemolysis occcurs?

A

extravascular

intravascular

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10
Q

what happens in extravascular haemolysis?

A

RBCs are taken up by the reticuloendothelial system - mainly the spleen and liver

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11
Q

what type of haemolysis is more common - intra or extra vascular?

A

extravascular

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12
Q

what organ changes can be seen in extravascular haemolysis?

A

splenomegaly

hepatomegaly

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13
Q

what is RBC product is released in extravascular haemolysis?

A

protoporphyrin

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14
Q

what findings would be seen in extravascular haemolysis?

A

unconjugated bilirubinaemia

urobilinogenuria

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15
Q

what are two possible consequences of high bilirubin levels in extravascular haemolysis?

A

jaundice

gallstones

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16
Q

what happens in intravascular haemolysis?

A

red cells are destroyed within the circulation, causing their contents to spill into the blood

17
Q

what four findings are seen in intravascular haemolysis?

A

haemoglobinaemia
methaemalbuminaemia
haemoglobinuria
haemosiderinuria

18
Q

what is haemoglobinaemia?

A

free Hb in the circulation

19
Q

what is methaemalbuminaemia?

A

free haem joining with albumin in the blood

20
Q

what colour is urine in haemoglobinuria?

A

pink

turns black when left to stand

21
Q

name some possible causes of intravascular haemolysis

A

ABO incompatibility
G6PD deficiency
severe falciparum malaria

22
Q

what tests should be done to confirm that a patient is in a haemolytic state?

A 
FBC + blood film 
reticulocyte count 
serum unconjugated bilirubin 
serum haptoglobins
urinary urobilinogen
23
Q

what finding on blood film is suggestive of RBC membrane damage?

A

spherocytes

24
Q

what finding on blood film is suggestive or RBC mechanical damage?

A

red cell fragments

25
Q

what finding on blood film is suggestive of RBC oxidative damage?

A

heinz bodies

26
Q

what does the direct coomb’s test do?

A

identifies antibodies bound to red cells

27
Q

what are some possible causes of premature destruction of red cells?

A

autoimmune haemolysis

mechanical destruction

28
Q

what is the “warm” autoantibody in autoimmune haemolysis?

A

IgG

29
Q

name some causes of autoimmune haemolysis with IgG autoantibodies present

A

idiopathic
SLE
lymphoproliferative disorders

30
Q

what is the “cold” autoantibody in autoimmune haemolysis?

A

IgM

31
Q

name some causes of autoimmune haemolysis with IgM autoantibodies

A

idiopathic

infections

32
Q

name some possible causes of mechanical red cell destruction

A 
DICC
HUS
leaky heart avalves 
infections 
burns
33
Q

what type of anaemia can be caused by a leaking heart valve?

A

microangiopathic haemolytic anaemia (MAHA)

34
Q

what are some possible acquired causes of an abnormal RBC membrane?

A

liver disease
vit E deficiency
PNH

Y3 Haematology (23 decks)

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