haemolytic anaemia Flashcards
—- is a condition in which mature red cells are destroyed faster than they are made
haemolytic anemia
the consequences of haemolytic anamia are:
1- the release of red cells into the blood stream causes high levels of —— these can be detected in the the blood and are clues than haemolyisis is occurring
2- the condition can be —- until haemoglobin levels are dangerously —-
3- — haemolytic can be life threatening and requires emergency management
- bilirubin and LDH ( lactate dehydrogenase )
- asymptomatic
- low
- rapid
the causes of anemia include:
1- abnormality intrinsic to red cells as:
2- abnormality extrinsic
1- sick cell anemia , g6pd deficiency , heredity spherocytosis , thalasmeia
2- immune , mechanical
Autoimmune haemolytic anaemia :
1- Warm antibody AIHA- by an —- which include:
2- Cold antibody AIHA-by an —– which include:
- IgG as : lymphoma , cll , collagen , vascular ds
- IgM as: seen in cold agglutin ds, mycoplasma EB virus
diagnosis for autoimmune haemolytic anaemia include:
1- reticulocytosis , elevated LDH , indirect hyperbilrubinanmia
2- peripheral blood smear may show spherocytes , occasional fragmented rbc
3- positive dat ( direct coobs test)
4- warm AIHA : igG+ and/or c3+
5- cold AIHA: igG- and c3+
history taking in haemolytic anaemia :
1- symptoms which are similar to causes of anaemia but are —
2- —- symptoms includes cough fever and ill contacts
3- recent — as malaria
4- — history
5- previous —–
- shorter
- infectious
- travel
- family
- transfusion ( check for labs for previous transfusions , maybe distant or unknown history )
( check slide 10 important )
the — antiglobuin Coomb test is used to detect antibodies that are stuck in the surface of the rbc , positive test indicates hameolysis
the —- antiglobuin Coombs test used to detect if there are antibodies in the bloodstream serum and its useful for transfusion
- direct
- indirect
—- is when the genetic code in hb is abnormal such as ——-
- inherited hb defect
- sickle cell disease mutation
when the globin chains are normal but rate of sythesis is reduced and causes accumalation of abnormal chain leads to structural defects
thalassemia major and minor which are inherited hb defect
in sick cell disease mutation the glutamic acid is replaced with —- which causes an increase has with rbc aggregation at – 02 tension
in sickle cell anemia the coinhertance of —- and another abnormal —–
sickle cell trait : inheritance of – gene encoding for HBS
- valine
- low
- HBS
- b chain variant
- one
1-in — haemolytic anemia the HbS in —– state which is 50x less — than HBA
2- insoluble chains —- in rbc with distortion of membrane and cell becomes — shaped
3- Sickle RBC only lasts —–
4- deformed cells more —- and cant — the microcirculation
5- it causes ——
6- —- change and blood viscosity is high > venous stasis > local obstruction > tissue hypoxia > more sickling > tissue infraction
- chronic
- deoxygenated
- soluble
- crystallises
- crescent shaped
- 10-20 days
- rigid
- pass
- vascular occlusion
- structural
sickling can be —- and may be participated by —–
- spontaneous
- hypoxia , acidosis , hypertension , infection , dehydration , hypothermia
other complications for sickle cell disease include :
- osteomyelitis ( infected bone) why? Because of their shape, these erythrocytes are more likely to become trapped in small slow-flowing vessels, leading to vaso-occlusion
- gall stones bc migrate and block the common bile duct leading to acute abdomen.
- renal failure blood flow becomes less so it causes kidney damage n Renal failure
- cardiac failure : sickle shape of the cells make them more likely to cause blockages, but they can also damage the lining of blood vessels, resulting in inflammation
- chronic leg ulcers : due to inflammation and infection
—- a group of inherited conditions that cause reduced sythesis of either alpha or beta globin genes
thalassemia ( check slide 21 )
laboratory tests for haemolytic anemia includes :
- hb reduced
- haptoglobin decreased as it mops up degenerative fragments of rbc and rapidly breaks down
- LDH increased
- bilirubin increased due to breakdown of heat
- reticulocytosis in peripheral blood
- erythroid hyperplasia in bone marrow
- coombs test may be positive if immune
- blood film - look for the shape of rbc
- electrophoresis and molecular tests
