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Haem > haemolysis > Flashcards

haemolysis Flashcards

1
Q

what is haemolysis?

A

breakdown of RBC

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2
Q

how does haemolysis present?

A

normocytic or false macrocytic anaemia - pale, fatigue
jaundice
dark urine
splenomegaly
hepatomegaly

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3
Q

what are the clinical results for intravascular haemolysis?

A

low haptoglobin
increased LDH
increased urine Hb and hemosiderin
schistocytes

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4
Q

what are the causes of intravascular haemolysis?

A

G6PD deficiency
ABO mismatch
malaria
drug-induced

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5
Q

what are the clinical results for extravascular haemolysis?

A

increased unconjugated bilirubin
increased LDH
splenomegaly
target cells

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6
Q

what are the causes of extravascular haemolysis?

A

thalassaemia
sickle cell
hereditary spherocytosis
autoimmune haemolytic anaemia

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7
Q

what immunoglobulins are involved in autoimmune acquired haemolysis?

A

warm IgG
cold IgM

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8
Q

what are the causes of warm IgG autoimmune acquired haemolysis?

A

autoimmune (SLE)
drugs
infections

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9
Q

what are the causes of cold IgM autoimmune acquired haemolysis?

A

infections
lymphoproliferative disorders

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10
Q

what causes alloimmune acquired haemolysis?

A

haemolytic transfusion reaction

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11
Q

what causes mechanical autoimmune acquired haemolysis?

A

DIC
TTP
haemolytic uraemic syndrome (HUS)
infections
burns
prosthetic heart valve

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12
Q

what are acquired causes of abnormal cell membrane?

A

liver disease
vitamin E deficiency

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13
Q

what are congenital causes of abnormal cell membrane?

A

hereditary spherocytosis
altered spleen (inc transit time)

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14
Q

what are congenital causes of abnormal red cell metabolism?

A

G6PD deficiency
failure to generate ATP

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15
Q

what are genetic causes of abnormal haemoglobin?

A

sickle cell disease

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16
Q

how do we confirm haemolysis?

A

FBC - inc. reticulocytes, inc. serum unconjugated bilirubin, inc. urinary urobilinogen
inc. LDH - indicated increased cellular breakdown

17
Q

what does direct coomb’s test identify?

A

warm and cold autoimmune haemolytic anaemia

18
Q

what does indirect coomb’s test identify?

A

screening in antenatal care and RBC phenotypical for transfusions

19
Q

what type of transmission is G6PD deficiency?

A

x-linked

20
Q

what type of transmission is hereditary spherocytosis?

A

autosomal dominant

21
Q

how does G6PD deficiency cause haemolysis?

A

reduced NAPDH leads to oxidative stress, too much gutathione

22
Q

how will a patient with G6PD deficiency haemolysis present?

A

rapid onset jaundice and anaemia

23
Q

how does hereditary spherocytosis cause haemoylsis?

A

abnormal RBC shape
inc. sequestration in spleen
extravascular haemolysis

24
Q

how would a patient with hereditary spherocytosis haemolysis present?

A

young child
Fhx splenectomy
jaundice, mild anaemia, splenomegaly

25
Q

what would blood film show in G6PD deficiency haemolysis?

A

Heinz bodies
Bite cells

26
Q
A

Haem (30 decks)

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