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Haematology > Haemolytic Anaemia > Flashcards

Haemolytic Anaemia Flashcards

1
Q

Define Haemolytic Anaemia?

A

Premature erythocyte breakdown causing shortened erythocyte life span (<120 days) with anaemia

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2
Q

What is the hereditary aetiology of Haemolytic Anaemia?

A

Membrane Defects
Metabolic Defects
Haemoglobinopathies

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3
Q

What Membrane Defects can cause Haemolytic Anaemia?

A

Hereditary spherocytosis

Elliptocytosis

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4
Q

What Metabolic Defects can cause Haemolytic Anaemia?

A

G6PD deficiency

Pyruvate Kinase Deficiency

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5
Q

What haemoglobinopathies can cause Haemolytic Anaemia?

A

Sickle cell disease

Thalassemia

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6
Q

What is the Acquired aetiology of Haemolytic Anaemia?

A 
Autoimmune 
Isoimmune 
Drugs
Trauma 
Infection
Paroxysmal Nocturnal Haemoglobinuria
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7
Q

What is the Autoimmune cause of Haemolytic Anaemia?

A

Antibodies attach to erythocytes causing intravasular and extravascular haemolysis

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8
Q

What are the Isoimmune causes of Haemolytic Anaemia?

A

Transfusion reaction

Haemolytic disease of the newborn

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9
Q

What drugs can caused Haemolytic Anaemia?

A

Penicillin

Quinine

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10
Q

Why do some drugs cause Haemolytic Anaemia?

A

Caused by the formation of a drug-antibody-erythocyte complex

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11
Q

What are the Trauma causes of Haemolytic Anaemia?

A

Microangiopathic Haemolytic Anaemia (caused by RBC fragmentation in abnormal microcirculation)
E.g. haemolytic uraemic syndrome, DIC, malignant hypertension

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12
Q

What are the Infective causes of Haemolytic Anaemia?

A

Malaria

Sepsis

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13
Q

What is the epidemiology of Haemolytic Anaemia?

A

COMMON
Genetic causes are prevalent if African, Mediterranean and Middle Eastern populations
Hereditary spherocytosis is the most common inherited haemolytic anaemia in northern Europe

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14
Q

What are the presenting symptoms of Haemolytic Anaemia?

A

Jaundice
Haematuria
Anaemia

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15
Q

What are the signs of Haemolytic Anaemia on physical examination?

A

Pallor
Jaundice
Hepatosplenomegaly

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16
Q

What investigations would you do for Haemolytic Anaemia?

A 
Bloods 
Blood Film
Urine 
Direct Coombs' Test 
Osmotic fragility test or Spectrin mutation analysis
Ham's Test 
Hb Electrophoresis or Enzyme Assays
Bone Marrow Biopsy (Rarely Performed)
17
Q

What bloods do you do for Haemolytic Anaemia?

A

FBC
U&Es
Folate

18
Q

What do you look for specifically on a FBC for Haemolytic Anaemia?

A 
Low Hb 
High reticulocytes 
High MCV 
High unconjugated bilirubin
Low haptoglobin (a protein that binds to free Hb released by RBCs)
19
Q

What might we see on a blood film for Haemolytic Anaemia?

A

Leucoerythroblastic picture
Macrocytosis
Nucleated erythrocytes or reticulocytes
Polychromasia

20
Q

What specific abnormal cells do you see on a Blood Film for Haemolytic Anaemia?

A 
Spherocytes 
Elliptocytes 
Sickle cells
Schistocytes
Malarial parasites
21
Q

What do we see on Urinalysis for Haemolytic Anaemia?

A

High urobilinogen
Haemoglobinuria
Haemosiderinuria

22
Q

What is the Direct Coombs’ Test?

A

Tests for autoimmune haemolytic anaemia

Identifies erythocytes coated with antibodies

23
Q

How do we use Osmotic Fragility Test for Haemolytic Anaemia?

A

Identifies membrane abnormalities

24
Q

What is the Ham’s Test for Haemolytic Anaemia?

A

Lysis of erythocytes in acidified serum in paroxysmal nocturnal haemoglobinuria

25
Q

Why do we do a Hb Electrophoresis or Enzyme Assays for Haemolytic Anaemia?

A

To exclude other causes

Haematology (24 decks)

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