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Hematology > Hemolytic Anemia > Flashcards

Hemolytic Anemia Flashcards

1
Q

What is hemolysis

A

Premature distraction of erythrocytes

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2
Q

What causes hemolytic anemias

A

Increased rates of red cell destruction

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3
Q

Lifespan of red cells

A

90 to 120 days

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4
Q

What happens to the bone marrow when there is hemolytic anemia

A

There is a Eryhtroid hyperplasia

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5
Q

What cells are responsible for the removal of red cells that are destructed

A

Extra vascular macrophages of the reticuloendothelial system

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6
Q

In which organ does the removal of destructed red cell occur

A

Deliver the spleen and mostly the bone marrow

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7
Q

Breakdown pathway of normal red cell

A

Hemoglobin broken down to haem and globin

Globin broken down into amino acids

Haem broken down into iron and Protoporphyrin

Iron -> transferrin -> erythroblast

Protoporphyrrin-> free bilirubin -> bilirubin glucuronides in liver -> stercobilirubin -> faeces or urine ( urobilinogen)

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8
Q

Main organ that removes old and damaged red blood cells from circulation

A

Spleen

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9
Q

First way the body compensate when there is higher rates of red blood cell breakdown

A

By increasing production of red blood cell

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10
Q

Why is there jaundice in hemolytic anemia

A

Free BiliRubin from red blood cell destruction

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11
Q

Why do red blood cells are more susceptible to oxidative damage and a short abnormal life cycle

A

Because they lack mitochondria so rely mostly on glycolysis for materials needed to reduce oxidative damage

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12
Q

What is Intravascular hemolysis

A

Release of red blood cell contents into the bloodstream

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13
Q

Classification of hemolytic anemia based on site of hemolysis

A

Extravascular hemolytic disorder

Intravascular hemolytic disorders

Combination of both extra and Intravascular hemolysis

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14
Q

What happens in extravascular hemolysis

A

Red cell destruction occurs in the cells of the reticuloendothelial system

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15
Q

Laboratory signs of extravascular hemolysis

A

Indirect hyperbilirubinemia
Increased excretion of bilirubin by bile
Erythroid hyperplasia
hemosiderosis

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16
Q

Clinical states associated with extravascular hemolysis

A 
Auto immune hemolysis
delayed hemolytic transfusion reactions 
hemoglobinopathies 
hereditary spherocytosis
Hypersplenism
17
Q

What happens inIntravascular hemolysis

A

Destruction of red blood cell in the blood vessels

18
Q

What are the clinical states associated with Intravascular hemolysis

A 
Severe and extensive burns 
acute hemolytic transfusion reactions 
paroxysmal nocturnal hemoglobinuria 
severe microanngiopathic hemolysis 
physical trauma 
bacterial infections and parasitic infections
19
Q

Classification of Hemolytic anemia based on site of defects

A

Intrinsic defect

Extrinsic defect

20
Q

Classification of hemolytic anemia based on inherited or acquired States

A

Inherited hemolytic anemia mostly caused by intrinsic defects

Acquired hemolytic anemia mostly caused by extrinsic defect

21
Q

What disease is a an exception to the classification of inherited or acquired hemolytic anemia

A

Paroxysmal nocturnal hemoglobinuria is an exception because it’s acquired but has intrinsic defect

22
Q

disease linked with hereditary HA

A

Membrane defects - hereditary spherocytosis

Metabolic defects - G6PD

Hemoglobin defects - sickle cell disease

23
Q

Acquired HA disease conditions

A 
Autoimmune 
Alloimune 
Red cell fragmentation syndrome 
March Hemoglobinemia 
Infections 
Chemical and physical agents 
PNH
24
Q

Diagnosis of hemolytic anemia

A

Family history
Ethnic origin (Méditerranean and Chinese with G6PD )
Past history like neonatal jaundice
Triggering events - drugs history, infections

25
Q

Clinical features of HA

A 
Pallor of mucus membrane 
Jaundice 
Splenomegaly 
Dark urine 
Pigment gall stones
Ulcers around ankle
Aplastic crisis 
Growth retardation 
Hypertrophic skeletal changes
26
Q

Laboratory findings of HA which shows increased red cell breakdown

A 
High serum bilirubin Unconjugated 
Increased urine urobilinogen 
Increased fecal stercobilinogen 
Reduced serum haptoglobin 
Reduced serum hemopexin
Increased LDH
27
Q

Peripheral blood film findings in HA

A 
Normocytic and Macrocytic red cells
Polychromasia
Nucleated red blood cells
Schistocyte
Microspherocytes
Elliptocytes
Helmets cells
Reticulocytes
28
Q

HA Findings in bone marrow

A

Erythroid hyperplasia

29
Q

Test that shows shortening of red cell survival

A

51 Cr labelling

30
Q

Reticulocytosis is a sign of …

A

Increased red cell production

31
Q

Reticulocyte stain

A

New methylene blue & brilliant Crésyl blue

32
Q

Lab feature of Intravascular hemolysis

A

Hemoglobinaemia
Hemoglobinuria
hemosiderinuria
Methaemalbumin

33
Q

Color appearance of urine in hemoglobinuria

A

Dark

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