Hemolytic Anemia, Congenital Spherocytic Anemia, Hemodilution (Exam 3) Flashcards
What is hemolytic anemia?
RBC hemolysis inside the vessels (intravascular) but outside macrophages
What are the 2 types of causes of hemolytic anemia?
intrinsic and extrinsic
What is the intrinsic cause of hemolytic anemia?
defect in the RBC makeup itself
What are the extrinsic causes of hemolytic anemia (2 examples)
outside factors: toxins, anti-RBC antibodies
What is the negative effect of drug reactions on stem cells?
aplastic anemia | BM aplasia with pancytopenia
What are the 5 negative effects of drug reactions on RBCs?
selective erythroid aplasia | impaired erythropoiesis | megaloblastic anemia | hemolysis | antibodies against RBC
What drug can induce impaired erythropoiesis?
dilantin
Which drug can induce production of antibodies against RBC?
penicillin
Which 2 molecules do megaloblastic anemia affect the absorption of?
B12 | folate
What are the 3 negative effects of drug reactions on WBCs? Which type is an immunological and non-immunological effect?
agranulocytosis | anti-WBC antibodies (immunological effect) | neutropenia (non-immunological effect)
What are the 2 negative effects of drug reactions on platelets?
thrombocytopenia purpura (immunologic) | impaired platelet function
What is congenital spherocytic anemia?
genetic | abnormal RBC membrane = leads to RBC lysis
How often does congenital spherocytic anemia occur?
1 in every 5,000 people
What is the mechanism of disease for congenital spherocytic anemia?
abnormal lipid : protein ratio on RBC membrane = abnormal shape = susceptible to lysis (also occurs with elliptocytes)
What are the 3 findings (symptoms) of congenital spherocytic anemia?
hemolytic anemia | spleenomegaly (due to RBC lysis) | normal RBC indices (MCH, MCV, MCHC)
What are the 3 findings with hemolytic anemia?
jaundice | high bilirubin levels | low free haptoglobin levels
What is the treatment for congenital spherocytic anemia?
splenectomy = 100% cure (some lysis still happens, not extensive)
What is hemodilution?
change in blood volume | dilution of blood cells due to increase body water | increases BP
What are the 5 causes of hemodilution?
pregnancy | congestive heart failure | hepatic & renal insufficiency | medications
What are the 2 effects of hemodilution on a pregnant patient?
develop hemorrhoids | immunosuppression (susceptible to infections)
What is the effect of hemodilution on people who have congestive heart failure?
ankle edema | heart not pumping efficiently + gravity draws fluid to ankles = accumulate there
How do hepatic and renal insufficiency cause hemodilution?
liver and kidney not excreting water efficiently out of the body
What are the 4 clinical presentations of anemia for someone who has hemodilution?
normochromic, normocytic anemia | no sign of increase RBC production or destruction | increase plasma volume | lower hematocrit
In hemodilution, what is apparent anemia?
more plasma volume than RBC but same # of RBCs
In hemodilution, what is apparent polycythemia?
less plasma volume than RBC but same # of RBCs
