hemolytic anemias Flashcards
what can be the cause of hemolytic anemia
intravascular rupture of red cells or increased uptake of red cells by phagocytes in spleen and liver (reticuloendothelial system)
what does visible hemolysis mean
looking at a tube of serum or urine in a tube next to light and seeing free hemoglobin
what normally happens to free hemoglobin in healthy patient
filtered out by kidney
when is free hemoglobin evident in urine
severe hemolysis and/or renal disease
how can red cells get into urine
tissue damage between urethra and kidney
what is needed to tell difference between red cells and hemoglobin in blood, which can have similar appearance
microscopy
what is LDH
lactate dehydrogenase
why can you see a ton of LDH in serum with hemolysis
there is a ton of LDH in red blood cells
is LDH specific for red blood cell lysis
no bc it is in other cells too such as lymphoblasts in context of acute leukemia
what is unconjugated bilirubin
end product of heme catabolism
when will you see elevated bilirubin levels
if free hemoglobin is dumped into serum faster than it can be metabolized by liver
how can you see if you have elevated bilirubin
serum turns yellow
what other diseases can cause elevated bilirubin
gilberts syndrome (benign liver anomaly) and liver disease
what is haptoglobin
protein that binds free hemoglobin and removes it from blood
if a lot of free hemoglobin is being cleared what happens to haptoglobin levels
reduced
how can reduced haptoglobin levels be masked
it increases in association with infectious/inflammatory states (acute phase reactant)
what does workup of any hematologic disease begin with
peripheral blood smear
where is there often evidence of hemolysis
peripheral blood smear and reticulocyte count
what is plasma
liquid portion of blood
what is serum
liquid portion after blood clots
what is icterus
technical term for jaundice
what can be seen with the red blood cells in lab findings with hemolytic anemia
compensatory red blood cell production (polychromasia, nucleated rbcs, increased reticulocytes)
what are multiple possible etiologies of hemolysis
genetic, neoplastic/acquired genetic, infectious agents,autoimmune, iatrogenic/toxic, nutritional, multifactorial, idiopathic
how is a red blood cell put together
membrane (cable reinforced), hemoglobin, simplified atp generating system, antioxidant system, surface proteins that inhibit complement fixation
what are genetic causes of hemolytic anemia organized around
components of red blood cell
