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FINALS - HAEM > haemolytic anaemia > Flashcards

haemolytic anaemia Flashcards

1
Q

symptoms haemolytic anaemia

A

low Hb, reticulocytosis, low haptoglobin, raised LDH and bilirubin

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2
Q

what are reticuloytes

A

RBC released from bone marrow, mature after 2-3 days

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3
Q

bloods reticuloytes

A

polychromatic, blue

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4
Q

where does extravascular haemolysis occur

A

spleen, liver, lymph nodes

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5
Q

causes of extravascular haemolytic anaemia

A

haemoglobinopathy // spherocytes // haemolytic disease newborn // warum autoimmune haemolytic anaemia

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6
Q

findings extravascular haemolysis

A

bilirubin, splenomegaly, gallstones, jaundice

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7
Q

in intravascular haemolytic anaemia what does free Hb bind too

A

haptoglobin + albumin

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8
Q

lab findings in intravascular haemolytic anaemia

A

Hemoglobinemia (Hb), Methaemalbuminaemia, hemosiderinuria (fe) , haemolgoburia

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9
Q

urine in intravascular haemolysis

A

pink –> black on standing

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10
Q

causes intravascular haemolytic anaemia

A

blood transfusion // G6PD // heart valve // TTP // DIC // HUS // Paroxysmal nocturnal haemoglobinuria // cold autoimmune haemolytic anaemia

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11
Q

inherited causes haemolytic anaemia

A

spherocytosis // G6PD // haemoglobinopathy

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12
Q

acquired immune haemolytic anaemia

A

autoimmune // alloimmune eg transfusion, haemolytic newborn // drug eg methyldopa

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13
Q

causes non-immune haemolytic anaemia

A

TTP, HUS, DIC // prsothetic heart valves // paroxysmal nocturnal haemoglobinuria // malaria // dapson // Zieve syndrome

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14
Q

what is Zieve syndrome

A

alcohol binge –> haemolysis, jaundice, hyperlipideamia

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15
Q

how is non-autimmune vs autoimmune acquired haemolytic aneamia differentiated

A

coombes

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16
Q

inheritance hereditary spherocytosis

A

autosomal dominant

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17
Q

symptoms hereditary spherocytosis

A

northern european // failure to thrive // jaundice, gallstones, splenomegaly (extraV) // aplastic crisis

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18
Q

what precipitates aplastic crisis

A

parvovirus

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19
Q

bloods + lab findings hereditary spherocytosis

A

film - spherocytes // bloods = raised reticulocytes, raised MCHC, raised bilirubin, low Hb

20
Q

if blood tests borderline for hereditary spherocytosis what testing is diagnostic

A

EMA binding test (+ cyroheamolysis test // atypical = eletophoresis)

21
Q

mx hereditary spherocytosis

A

acute crisis = supportive +/- transfusion // long term = folate + splenectomy

22
Q

inheritance G6PD def

A

X linked (more common in men)

23
Q

consequences G6PD deficiency

A

reduces NADPH + glutathione so more oxidation on red blood cells

24
Q

what can cause G6PD deficiency presentation

A

infection, fava beans, medications

25
Q

what medications can cause G6PD deficiency presentation

A

antimalarial // cipro // sulpha - suphonamides, sulphalazine, sulfonyurea

26
Q

symptoms G6PD deficiency

A

neonatal jaundice // intravascular haemolysis // gallstones, splenomegaly

27
Q

blood film G6PD deficiency

A

heinz bodies // bite and blister cells

28
Q

diagnosis G6PD deficiency

A

enzyme assay 3 months after acute episode

29
Q

specific feature autoimmune haemolytic anaemia

A

positive coombes

30
Q

what temp + site is warm autoimmune haemolytic anaemia

A

haemolysis that occurs at normal body temperatures, usually in the spleen

31
Q

causes warm autoimmune haemolytic anaemia

A

idiopathic // SLE/ // lymphoma // CLL // methydlopa

32
Q

mx warm autoimmune haemolytic anaemia

A

steroids +/- rituximab

33
Q

antibody warm autoimmune haemolytic anaemia

A

IgG

34
Q

temp + site cold autoimmune haemolytic anaemia

A

haemolysis at 4C - intravascular

35
Q

antobodies in cold autoimmune haemolytic anaemia

A

IgM

36
Q

symptoms cold autoimmune haemolytic anaemia

A

reynauds and acrocynaosis

37
Q

causes cold AIHA

A

lymphoma, infection

38
Q

what type of haemolysis is paroxysmal nocturnal haemoglobinuria

A

acquired non-immune - mainly intravascular

39
Q

features paroxysmal nocturnal haemoglobinuria

A

haemolytic anaemia // pancytopaenia // haemoglobinuria // thrombosis (budd chairi) // aplastic anaemia

40
Q

what is haemoglobinuria

A

dark urine

41
Q

diagnosis paroxysmal nocturnal haemoglobinuria

A

flow cytometry (low CD59/55)

42
Q

mx paroxysmal nocturnal haemoglobinuria

A

replacement // anticoag // transplant // eculizumab

43
Q

triad HUS

A

AKI // haemolytic anaemia // thrombocytopenia // (proceeding diarrhoea illness)

44
Q

causes HUS

A

e.coli 0.157 (shiga toxin)

45
Q

invx HUS

A

anaemia <8 // low platelets // U+E // stool culture shiga toxins

46
Q

blood film HUS

A

shistocytes + helmet cell

47
Q

mx HUS

A

fluids, transfusion, dialysis eculizumab // (NO ABX)

FINALS - HAEM (18 decks)

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