Haemolytic Anaemia - HS/G6PD

Question 1

G6PD blood film in crisis

Answer 1

Blister cells
Bite cells
Heinz bodies
Basophilic stippling
Normocytic normochromic anaemia

Question 2

Differential diagnosis for G6PD

Answer 2

Oxidative haemolysis

Question 3

G6PD tests

Answer 3

First - check haptoglobin, LDH, reticulocytes, bilirubin
Second - G6PD assay and Heinz body stain

Question 4

G6PD post splenectomy blood film

Answer 4

Howell-jolly bodies
Pappenheimer bodies
Spherocytes
Basophilic stippling
NRBC

Question 5

Platelets post splenectomy

Answer 5

Severe Thrombocytosis

Question 6

Differential diagnosis of G6PD post splenectomy

Answer 6

Hyposplenism
Auto splenectomy

Question 7

TTP blood film

Answer 7

Polychromasia
Schistocytes
Burr cells
NRBC

Question 8

Platelets and WBC in TTP

Answer 8

Platelets - severe thrombocytopenia
WBC increased

Question 9

Differential diagnosis for TTP

Answer 9

HUS
DIC
mechanical haemolysis
ADAMTS13 deficiency

Question 10

Further tests for TTP

Answer 10

Coagulation screen
Renal tests
Blood/stop cultures (shig and sal in HUS)
Patient history
clinical symptoms (neurological effects more likely)
Are they a woman 30-40 or a child
D dimer
Haptoglobin, LDH, bilirubin, reticulocyte

Question 11

Mechanical haemolysis blood film

Answer 11

Oddly shaped fragments
Schistocytes
Polychromatic cells
Burr cells

Question 12

Platelets in mechanical haemolysis

Answer 12

Normal to increased
Differentiates from TTP which is a big thrombocytopenia

Question 13

Differential diagnosis for mechanical haemolysis

Answer 13

TTP
HUS
DIC

Question 14

Mechanical haemolysis tests

Answer 14

Same as TTP

Question 15

HS blood film

Answer 15

Spherocytes
Polychromasia, anisocytosis
Burr cells
Some normal looking RBC
Reticulocytosis

Question 16

Differential diagnosis when you see Spherocytes

Answer 16

AIHA
HS
Drug induced
Infection with C perfingens
Snake venoms
HDNB

Question 17

Further tests for HS

Answer 17

To differentiate from AIHA do a DAT and an EMA
HS is positive for EMA and AIHA is positive for a DAT
ALSO check haptoglobin, bilirubin, reticulocytes, LDH

Question 18

Autoimmune haemolytic anaemia blood film

Answer 18

Polychromasia
Spherocytes - more irregular shape
NRBC
Rare - howell jolly body

Question 19

WBC in AIHA

Answer 19

Leucocytosis

Question 20

Differential and Tests for AIHA

Answer 20

Same as HS

Question 21

Schistocytes are found in

Answer 21

TTP
Mechanical haemolysis
Burns
Drugs toxins

Question 22

Stomatocytosis found in

Answer 22

HS
liver disease
Alcohol

Question 23

Where are howell jolly bodies seen

Answer 23

Post splenectomy
Megaloblastic anaemia
Sickle cell maybe