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3MB Haematology > Haemolysis > Flashcards

Haemolysis Flashcards

1
Q

What is haemolysis?

A

Premature red cell breakdown

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2
Q

Why are red cells particularly susceptible to damage?

A

Biconcave shape
Limited metabolic reserve; rely on glycolysis
Can’t generate new protein once circulating

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3
Q

What is meant by compensated haemolysis?

A

Increased red cell destruction followed by increased red cell production
i.e. Hb is maintained

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4
Q

What is decompensated haemolysis, AKA haemolytic anaemia?

A

Increased red cell destruction exceeding level of red cell production
i.e. Hb not maintained

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5
Q

What are the consequences of haemolysis?

A 
Erythroid hyperplasia (increased bone marrow RBC turnover)
Excess RBC breakdown products (bilirubin)
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6
Q

What are the 2 bone marrow responses to haemolysis?

A

Reticulocytosis

Erythroid hyperplasia

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7
Q

Reticulocytes in the circulation are diagnostic of haemolysis. True/False?

A

False

Can be present in bleeding, iron therapy, anaemia etc.

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8
Q

What are the 2 classifications of haemolysis that make it easier for us to identify the cause?

A

Extravascular (more common)

Intravascular

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9
Q

What does extravascular haemolysis involve?

A

Hyperplasia at site of destruction
Release of protoporphyrin, resulting in unconjugated jaundice
i.e. normal blood products in excess

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10
Q

What does intravascular haemolysis involve?

A

Red cells destroyed in the circulation and spill contents

i.e. abnormal products

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11
Q

What are the 4 main features/products of intravascular haemolysis?

A

Haemoglobinaemia (free Hb in blood)
Methaemalbuminaemia
Haemoglobinuria (pink urine turns black)
Haemosiderinuria

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12
Q

What investigations are done to confirm haemolytic state?

A 
FBC + blood film
Reticulocyte count
Serum unconj. bilirubin
Serum haptoglobin
Urinary urobilinogen
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13
Q

What might be seen on a blood film in haemolysis when identifying a cause?

A 
Membrane damage (spherocytes)
Mechanical damage (red cell fragments)
Oxidative damage (Heinz bodies)
Sickle cells
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14
Q

What is the direct Coomb’s test used for?

A

Identifies antibody (and Complement) bound to red cells

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15
Q

Acute haemolytic transfusion reaction involves Ig? antibody and is usually an intravascular/extravascular haemolysis

A

Acute haemolytic transfusion reaction involves IgM antibody and is usually an intravascular haemolysis

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16
Q

Delayed haemolytic transfusion reaction involves Ig? antibody and is usually an intravascular/extravascular haemolysis

A

Delayed haemolytic transfusion reaction involves IgG antibody and is usually an extravascular haemolysis

17
Q

List some causes of mechanical red cell destruction

A

Disseminated intravascular coagulation
Haemolytic uremic syndrome
Leaky heart valve
Infection

3MB Haematology (12 decks)

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