haemolytic anaemia

Question 1

—- is a condition in which mature red cells are destroyed faster than they are made

Answer 1

haemolytic anemia

Question 2

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

Answer 2

• bilirubin and LDH ( lactate dehydrogenase )
• asymptomatic
• low
• rapid

Question 3

the causes of anemia include:
1- abnormality intrinsic to red cells as:
2- abnormality extrinsic

Answer 3

1- sick cell anemia , g6pd deficiency , heredity spherocytosis , thalasmeia
2- immune , mechanical

Question 4

Autoimmune haemolytic anaemia :
1- Warm antibody AIHA- by an —- which include:
2- Cold antibody AIHA-by an —– which include:

Answer 4

• IgG as : lymphoma , cll , collagen , vascular ds
• IgM as: seen in cold agglutin ds, mycoplasma EB virus

Question 5

diagnosis for autoimmune haemolytic anaemia include:

Answer 5

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+

Question 6

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 —–

Answer 6

• shorter
• infectious
• travel
• family
• transfusion ( check for labs for previous transfusions , maybe distant or unknown history )
  ( check slide 10 important )

Question 7

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

Answer 7

• direct
• indirect

Question 8

—- is when the genetic code in hb is abnormal such as ——-

Answer 8

• inherited hb defect
• sickle cell disease mutation

Question 9

when the globin chains are normal but rate of sythesis is reduced and causes accumalation of abnormal chain leads to structural defects

Answer 9

thalassemia major and minor which are inherited hb defect

Question 10

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

Answer 10

• valine
• low
• HBS
• b chain variant
• one

Question 11

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

Answer 11

• chronic
• deoxygenated
• soluble
• crystallises
• crescent shaped
• 10-20 days
• rigid
• pass
• vascular occlusion
• structural

Question 12

sickling can be —- and may be participated by —–

Answer 12

• spontaneous
• hypoxia , acidosis , hypertension , infection , dehydration , hypothermia

Question 13

other complications for sickle cell disease include :

Answer 13

• 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

Question 14

—- a group of inherited conditions that cause reduced sythesis of either alpha or beta globin genes

Answer 14

thalassemia ( check slide 21 )

Question 15

laboratory tests for haemolytic anemia includes :

Answer 15

• 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

Question 16

true or false:
- acute haemolytic can be brisk and life threatening

Answer 16

true
( check slide 24)

Question 17

chronic haemolysis is managed differently based on—–
if its due to immune hameolysis it may require —–
sickle cell and thalasemia need regular —- to sustain growth and life , will cause iron overload which also needs to be managed w medication or else can cause organ damage

Answer 17

• underlying cause
• long term immune suppremission which can follow remitting and relapsing course and if the underlying course like bone marrow malignancy then need to be treated
• transfusions
  ( check last slide )