hemolytic anemia

Question 1

generally what is hemolytic anemia ?

Answer 1

anemia caused by reduced life span of RBCC

Question 2

what are the types of immune hemolytic anemias ?

Answer 2

AIHA
drug induced haemolytic anemia
alloimmune hemolytic anemia

Question 3

what are the two types of AIHA ?

Answer 3

warm
cold

Question 4

what is the pathogenesis and what type of haemolysis is associated with warm AIIHA ?

Answer 4

IgG is associated
spherocytes are formed
works at warm temperature
extravascular haemolysis

Question 4

what are thee causes of warm AHIA ?

Answer 4

idiopathic
secondary to an autoimmune disease
after methyl dopa ( True AIHA )
or due to antibody directed against drug

Question 5

what is the pathogenesis in cold AHIA and what type of haemolysis does it cause ?

Answer 5

IgM directed , works at body temperatures and below
intravascular haemolysis

Question 6

what infections are associated with cold AHIA ?

Answer 6

mycoplasma and EBV

Question 7

what falls under alloimmune haemmolytic anemia ?

Answer 7

delayed transfusion reactions
haemolytic disease of the newborn

Question 8

what are the non immune causes of hemolytic anemia ?

Answer 8

MAHA
paroxysmal nocturnal haemoglobinuria

Question 9

what are examples of MAHA ?

Answer 9

hemolytic uraemic syndorme
thrombotic thrombocytopenia purpura
disseminated intravascular coagulation
HELLP syndrome

Question 10

what are the general features associated with all types of hemolytic anemias ?

Answer 10

anemia
jaundice
splenomegaly
increased incidence of pigment gallstones

Question 11

what can bee seen on blood film indicating cold AIHA ?

Answer 11

red blood cell agglutinates

Question 12

what are the lab evidence of haemolysis ?

Answer 12

anemia
raised reticulocyte count
raised bilirubin
raised urinary urobilinogen
raised LDH
reduced haptoglobin

Question 13

how can we know if this haemolysis is immune or non immune ?

Answer 13

using the direct Coombs test
also known as direct antigen test

Question 14

what test can be used to determine iff u have a reaction against a a blood transfusion ?

Answer 14

indirect Coombs test

Question 15

what does low levels of haptoglobin indicate ?

Answer 15

hemolysis

Question 16

how can methaemalbuminaemia be confirmed ?

Answer 16

positive schumms test

Question 17

haemolysis occurring a few days after transfusion with a positive coombs ?

Answer 17

delayed hemolytic transfusion reaction

Question 18

what would establish a diagnosis of delayed hemolytic transfusion reaction ?

Answer 18

new red cell alloantiibody

Question 19

autoimmune hemolysis in a patient with lymphadenopathy and lymphocytosis should point you to what direction ?

Answer 19

lymphoid malignancy

Question 20

acute febrile illness with RBC agglutinate on blood film will indicate ?

Answer 20

mycoplasma infection

Question 21

patient presenting with haemolysis , fever, MAHA, CNS involvement, AKI and thrombocytopenic purpra is diagnostic for ?

Answer 21

TTP

Question 22

what is diagnostic in TTP ?

Answer 22

reduction in ADAMST13 activity

Question 23

anemia, abdominal pain , intermittent haemoglobinuria ?

Answer 23

paroxysmal nocturnal hemoglobinuria

Question 24

what is the management of acquired hemolytic anemia ?

Answer 24

folic acid 5mg daily
transfusion
treatment of underlying cause