Hemolytic Anemia

Question 1

Two types of hemolytic anemia

Answer 1

Acquired vs congenital

Question 2

Congenital Hemolytic Anemias

Answer 2

Sickle Cell
Thalassemia
Hereditary Spherocytosis
G6PD deficiency

Question 3

Acquired Hemolytic Anemias

Answer 3

Medications
Immune
Microangiopathic
Infections
Physical agents

Question 4

Medications causing hemolytic anemia

Answer 4

Dludarabine, bendamustine, quinine, penicillins, methyldopa

Question 5

Schistocytes and thrombocytopenia

Answer 5

TTP-HUS, DIC, HELLP

Question 6

Schistocytes in pt with prothetic heart valve

Answer 6

Valve leak

Question 7

Erythrocyte agglutination

Answer 7

Cold agglutinin hemolysis (mycoplasma, CLL, lymphoproliferative disease

Question 8

Spherocytes

Answer 8

AIHA, Hereditary spherocytosis

Question 9

Target cells

Answer 9

Thalassemia, hemoglobinopathy, liver disease

Question 10

Bite Cells

Answer 10

G6PDD

Question 11

Tests for Hemolytic anemia

Answer 11

DAT (Coombs), Cryohemolysis and eosin 5-maleimide, Cold agglutinin, Hgb electrophoresis, G6PD activity measurement, Flow cytometry for CD55, 59

Question 12

DAT (Coombs)

Answer 12

Warm autoimmune hemolytic anemia

Question 13

Cryohemolysis test and eosin-5-maleimide binding test

Answer 13

Hereditary spherocytosis

Question 14

Cold agglutinin

Answer 14

cold agglutinin disease

Question 15

Hgb electrophoresis

Answer 15

Thalassemia, hemoglobinopathies

Question 16

Flow cytometry for CD55, 59

Answer 16

PNH

Question 17

Patients with sickle cell disease or other hemolytic anemias need

Answer 17

Pneumococcal , H flu, Flu, meningococcal vaccines

Question 18

Chronic hemolytic anemias require

Answer 18

folic acid

Question 19

Treatment for AIHA

Answer 19

Glucocorticoids, splenectomy

Question 20

Cold agglutinin disease treatment

Answer 20

avoid cold

Ritucan

Question 21

TTP treatment

Answer 21

Plasma exchange

Question 22

Hereditary spherocytosis treatment

Answer 22

splenectomy

Question 23

Severe thalassemia treatment

Answer 23

HSCT

Question 24

PNH treatment

Answer 24

eculizumab, HSCT

Question 25

Hereditary spherocytosis may present as

Answer 25

anemia, jaundice, splenomegaly, gallstones

Question 26

Sickle Cell patient with liver disease may have

Answer 26

viral hepatitis, iron overload from transfusions, ischemic-induced liver crisis

Question 27

Hydroxyurea is contraindicated in

Answer 27

pregnancy and renal failure

Question 28

What opioid should not be used in SCD

Answer 28

meperidine

Question 29

Alpha Thalassemia clinical findings with each gene deletion

Answer 29

1 gene- silent carrier
2 genes- Trait; mild microcytic anemia
3 genes- Hgb H (B4)Sever anemia, early death- needs intermittent transfusions
4 genes- hydrops, fetal death

Question 30

Beta thalassemis clinical findings with each gene deletion

Answer 30

1 gene- B Thal minor (trait)- no or mild anemia
2 genes- B Thal major- bad- transfusions, HSCT, splenomegaly
Intermedia- compound heterozygotes of two variants

Question 31

Alpha an Beta thal trait are often confused with

Answer 31

IDA

Question 32

Difference between IDA and thalassemia trait

Answer 32

Ferritin and erythocyte count: Low in IDA, normal in thal
RDW: elevated in IDA, normal in thal
Hgb electrophor: Normal in IDA and Alpha thal trait; elevated A2 and fetal Hgb in Beta thal trait

Question 33

B thal can be associated with

Answer 33

iron overload in the absence of transfusions