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Haem/Onc MRCP > Haemolytic anaemia > Flashcards

Haemolytic anaemia Flashcards

1
Q

What are the causes of intravascular haemolysis?

A

Mismatched blood transfusion
G6PD deficiency
Paroxysmal nocturnal haemoglobinuria
Cold autoimmune haemolytic anaemia
Red cell fragmentation
- TTP
- DIC
- HUS
- mechanical heart valves

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2
Q

What causes extravascular haemolysis?

A

Haemoglobinopathies
- sickle cell
- thalassaemia
Hereditary spherocytosis
Haemolytic disease of newborn
Warm autoimmune haemolytic anaemia

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3
Q

What would be a classic presentation of intravascular haemolysis?

A

Systemic shock - fever, tachycardia, hypotension, AKI
Schistocytes on blood film
Raised LDH +++

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4
Q

What would be a classic presentation of extravascular haemolysis?

A

Less severe symptomatically
Splenomegaly/hepatomegaly

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5
Q

What is the most common type of autoimmune haemolytic anaemia?

A

Warm haemolytic anaemia

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6
Q

What are the causes of warm AIHA?

A

Idiopathic
Autoimmune disease - eg lupus
Neoplasm - CLL, lymphoma
Drugs - eg methyldopa

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7
Q

What is the management of warm AIHA?

A

Steroids +/- Rite
Management of underlying condition

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8
Q

What antibody mediates warm AIHA?

A

IgG

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9
Q

What antibody mediates cold AIHA?

A

IgM

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10
Q

What type of haemolysis does warm AIHA cause?

A

Extravascualr haemolysis

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11
Q

What type of haemolysis does cold AIHA cause?

A

Intravascualr haemolysis

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12
Q

What are the common causes of cold AIHA?

A

Neoplasm - lymphoma
Infection - EBV, mycoplasma

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13
Q

What is the classic presentation of cold AIHA?

A

Raynaud’s
Acrocyanosis (blue discolouration peripheries)

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14
Q

What is MAHA?

A

Microangiopathic haemolytic anaemia

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15
Q

What is microangiopathic haemolytic anaemia?

A

Subgroup of haemolytic anaemias where haemolysis occurs in small blood vessels

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16
Q

What are the common causes of MAHA?

A

DIC
HUS
TTP
HELLP
Cancer
Drugs - rifampicin

17
Q

What is paroxysmal nocturnal haemoglobinuria?

A

Acquired disorder leading to intravascular haemolysis

18
Q

What are the features of paroxysmal nocturnal haemoglobinuria?

A

Haemolytic anaemia
Dark coloured urine, esp in morning
Thrombosis
Can cause pancytopenia

19
Q

How is paroxysmal nocturnal haemoglobinuria diagnosed?

A

Flow cytometry of blood - low CD59 and CD55

20
Q

What is the management of paroxysmal nocturnal haemoglobinuria?

A

Anticoagulation
Transfusion support
Stem cell transplant
Monoclonal antibodies against C5 show promise

Haem/Onc MRCP (18 decks)

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