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Blood > Haemolytic anaemia > Flashcards

Haemolytic anaemia Flashcards

1
Q

What are the three main things you can see on investigations that occur because of red cell breakdown?

A

^ Bilirubin (unconjugated)
^ urinary urobilinogen
^ Serum LDH (released from RBC)

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2
Q

How can you tell is extravascular haemolysis is most likely to be occurring?

A

Splenomegaly

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3
Q

How can you tell is intravascular haemolysis is most likely to be occurring?

A

^Free plasma Hb
Decrease in plasma haptoglobin
^Methaemalbuminaemia (Free Hb is broken down, and the haem binds to albumin)
Haemoglobinuria (red-brown urine)

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4
Q

How do you divide causes of haemolytic anaemia?

A

Acquired

Hereditary

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5
Q

How do you divide the acquired causes of haemolytic anaemia?

A

Immune/non-immune (or Coombs +ve/Coombs -ve)

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6
Q

How do you divide the Hereditary causes of HA?

A

Haemoglobinopathies
Enzymopathies
Membranopathies

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7
Q

Heinz bodies and bite cells are seen in which type of anaemia?

A

G6PD Deficiency

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8
Q

Schistocytes are seen in what condition causing HA?

A

MAHA - Microangiopathic haemolytic anaemia

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9
Q

What test is used to confirm spherocytosis?

A

Osmotic fragility test

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10
Q

Name 2 causes of MAHA

A

Mechanical heart valves

Marching

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11
Q

What two things can precipitate oxidative crises in G6PD deficiency pts?

A

Exposure to broad/fava beans

Henna

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12
Q

What can exacerbate haemolysis?

A

Infections - especially with parvoviruses - can lead to aplastic crisis

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13
Q

Treatment for spherocytosis?

A

Splenectomy

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14
Q

Treatment for thalassaemia?

A

Frequent transfusions

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15
Q

Treatment for sickle cell?

A

Avoid precipitants, Folic acid, penicillin and vaccinations (transfusions not often given)

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16
Q

Treament for G6PD deficiency?

A

Avoid precipitants, transfuse if necessary

17
Q

Treatment for warm AIHA?

A

Prednisolone

+/- splenectomy

18
Q

Treatment for cold AIHA

A

Avoid cold, treat underlying condition

19
Q

Treatment for PNH?

A

Supportive, Eculizumab

20
Q

What 4 things may a pt with HA present with?

A

Jaundice
Hepatosplenomegaly
Gallstones (due to ^bilirubin in haemolysis)
Leg ulcers (poor blood flow to LL)

21
Q

What 8 investigations would you run for suspected HA?

A

FBC, reticulocytes, bilirubin, LDH, haptoglobin, urinary urobilinogen, thick and thin films for malaria if travel Hx, blood film

22
Q

Pt presents with ?HA, on blood film they show hypochromic microcytic cells, Dx?

A

Thalassaemia

23
Q

Pt presents with ?HA, on blood film they show shistocytes, Dx?

A

MAHA

24
Q

Pt presents with ?HA, on blood film they show Heinz bodies, Dx?

A

G6PD Deficiency

25
Q

Pt presents with ?HA, on blood film they show abnormal cells, Dx?

A

Malignancy

Blood (7 decks)

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