Hemolytic Anemia, Congenital Spherocytic Anemia, Hemodilution (Exam 3)

Question 1

What is hemolytic anemia?

Answer 1

RBC hemolysis inside the vessels (intravascular) but outside macrophages

Question 2

What are the 2 types of causes of hemolytic anemia?

Answer 2

intrinsic and extrinsic

Question 3

What is the intrinsic cause of hemolytic anemia?

Answer 3

defect in the RBC makeup itself

Question 4

What are the extrinsic causes of hemolytic anemia (2 examples)

Answer 4

outside factors: toxins, anti-RBC antibodies

Question 5

What is the negative effect of drug reactions on stem cells?

Answer 5

aplastic anemia | BM aplasia with pancytopenia

Question 6

What are the 5 negative effects of drug reactions on RBCs?

Answer 6

selective erythroid aplasia | impaired erythropoiesis | megaloblastic anemia | hemolysis | antibodies against RBC

Question 7

What drug can induce impaired erythropoiesis?

Answer 7

dilantin

Question 8

Which drug can induce production of antibodies against RBC?

Answer 8

penicillin

Question 9

Which 2 molecules do megaloblastic anemia affect the absorption of?

Answer 9

B12 | folate

Question 10

What are the 3 negative effects of drug reactions on WBCs? Which type is an immunological and non-immunological effect?

Answer 10

agranulocytosis | anti-WBC antibodies (immunological effect) | neutropenia (non-immunological effect)

Question 11

What are the 2 negative effects of drug reactions on platelets?

Answer 11

thrombocytopenia purpura (immunologic) | impaired platelet function

Question 12

What is congenital spherocytic anemia?

Answer 12

genetic | abnormal RBC membrane = leads to RBC lysis

Question 13

How often does congenital spherocytic anemia occur?

Answer 13

1 in every 5,000 people

Question 14

What is the mechanism of disease for congenital spherocytic anemia?

Answer 14

abnormal lipid : protein ratio on RBC membrane = abnormal shape = susceptible to lysis (also occurs with elliptocytes)

Question 15

What are the 3 findings (symptoms) of congenital spherocytic anemia?

Answer 15

hemolytic anemia | spleenomegaly (due to RBC lysis) | normal RBC indices (MCH, MCV, MCHC)

Question 16

What are the 3 findings with hemolytic anemia?

Answer 16

jaundice | high bilirubin levels | low free haptoglobin levels

Question 17

What is the treatment for congenital spherocytic anemia?

Answer 17

splenectomy = 100% cure (some lysis still happens, not extensive)

Question 18

What is hemodilution?

Answer 18

change in blood volume | dilution of blood cells due to increase body water | increases BP

Question 19

What are the 5 causes of hemodilution?

Answer 19

pregnancy | congestive heart failure | hepatic & renal insufficiency | medications

Question 20

What are the 2 effects of hemodilution on a pregnant patient?

Answer 20

develop hemorrhoids | immunosuppression (susceptible to infections)

Question 21

What is the effect of hemodilution on people who have congestive heart failure?

Answer 21

ankle edema | heart not pumping efficiently + gravity draws fluid to ankles = accumulate there

Question 22

How do hepatic and renal insufficiency cause hemodilution?

Answer 22

liver and kidney not excreting water efficiently out of the body

Question 23

What are the 4 clinical presentations of anemia for someone who has hemodilution?

Answer 23

normochromic, normocytic anemia | no sign of increase RBC production or destruction | increase plasma volume | lower hematocrit

Question 24

In hemodilution, what is apparent anemia?

Answer 24

more plasma volume than RBC but same # of RBCs

Question 25

In hemodilution, what is apparent polycythemia?

Answer 25

less plasma volume than RBC but same # of RBCs