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Basic Haemotology (1204) > Introduction to Haemolytic Anaemia > Flashcards

Introduction to Haemolytic Anaemia Flashcards

1
Q

What is Haemolytic Anaemia

A

Anaemia due to an increase in red cell destruction with no impairment of BM function

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2
Q

True or false, HA is associated with the inability of the marrow to compensate for the increased red cell breakdown i.e. There is marrow failure.

A

False

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3
Q

By how much can normal marrow increase in production rate

A

6-8 N

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4
Q

What are the two sites of Haemolysis

A

Intravascular

Extravascular

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5
Q

True or false, Most HA are extravascular, i.e in the spleen

A

True

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6
Q

What is an exception of HA being acquired intrinsic

A

Paroxysmal nocturnal haemoglobinuria

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7
Q

True or false, most intrinsic HA are congenital and most extrinsic ones are acquired

A

True

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8
Q

What classification of HA is most useful clinically

A

Based on inheritance

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9
Q

What are the two types of Membranopathies

A

Hereditary Spherocytosis

Hereditary Elliptocytosis

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10
Q

What are the different types of Enzymopathies

A

Glycose 6- Phosphate dehydrogenase deficiency

Pyruvate kinase deficiency

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11
Q

What are the different classifications of inherited/congenital HA

A

Membranopathies
Enzymopathies
Haemoglobinopathies

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12
Q

What are he different types of Haemoglobinopathies

A

Sickle cell disease

Thalassemia

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13
Q

What are the different types of Acquired HA

A

Immune

Non-Immune

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14
Q

What are the different immune acquired HA

A

Autoimmune HA- idiopathic, secondary, drug induced
Incompatible blood transfusion
Haemolytic disease of the new born

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15
Q

What are the different Non immune Acquired HA

A 
MAHA (Microangiopathic haemolytic Anaemia)
Infections (malaria)
Chemicals/ drugs/ venom
Physical agents (thermal injury)
PNH
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16
Q

What are the clinical features of congenital HA

A

Anaemia
Jaundice
Splenomegaly
Gall stones

17
Q

What are the different crisis in congenital HA

A

Aplastic , Haemolytic

18
Q

What disease is associated with Aplastic crisis

A

Parovirus B19 infection

19
Q

What is the MOA of parovirus B19 infection

A

Faeco- oral, oral-oral, respiratory

20
Q

Parovirus B19 infection decreases which two blood cells components

A

Haemoglobin, Reticulocyte

21
Q

How long does Parovirus B19 infection last

A

6-8 days

22
Q

What occurs in haemolytic crisis

A 
Megaloblastic crisis
Splenomegaly
Cholelithiasis
Leg ulcers 
Skeletal abnormalities
23
Q

What deficiency causes megaloblastic crisis

A

Folate

24
Q

In cholelithiasis, is can be due to supersaturation of the bile with

A

Calcium bilirubinate

25
Q

What is stored in cholelithiasis

A

Black pigment

26
Q

What is expanded in skeletal abnormalities of congenital HA haemolytic crisis

A

Erythroid bone marrow

27
Q

What are some clinical features of acquired HA

A

Acute febrile illness
Pallor and other features of Anaemia
Jaundice

28
Q

What laboratory feature of Haem catabolism is identified

A

Unconjugated hyperbilirubinaemia

Increased urobilinogen

29
Q

What substance is increased as a laboratory feature of haemolytic Anaemia

A

Serum lactate dehydrogenase

30
Q

What substance is absent in the laboratory feature of haemolytic Anaemia

A

Haptoglobin

31
Q

What are signs of IV haemolysis in laboratory features of haemolytic Anaemia

A 
Haemoglobinaemia
Haemoglobinuria
Haemosiderinuria
Methaemalbuminaemia
Reduced serum haemopexin
32
Q

What are the features of accelerated erythropoiesis

A 
Reticulocytosis 
Macrocytosis
NRBC in blood (nucleated red blood cells)
Leucocytosis and thrombocytosis
BM erythroid Hyperplasia
33
Q

What are the different tests to find the cause of HA

A

RBC morphology
Antiglobulin test (Coombs test)
Osmotic fragility

34
Q 
What is associated with the prescence of:
Spherocytes 
Elliptocytes 
Echinocytes
Sickle cells 
Target cells 
Schistocytes 
Autoagglutination
Heinz bodies
A 
HS, AIHA
HE
PK def
SCD
Thal, HBC Disease
MAHA
Cold AIHA
G6PD deficiency
35
Q

What are the symptoms of the differential diagnosis Anaemia and reticulocytosis

A

Bleeding
Recovery from deficiency of iron/folate/B12
Recovery after marrow failure

36
Q

What are the symptoms of the differential diagnosis anaemia and acholuric jaundice

A

Ineffective erythropoiesis

Blood loss into body cavities/tissue

37
Q

What is treatments are used as a supportive measure

A

transfuse where appropriate
splenectomy (sometimes)
steroids (sometimes)
folate supplementation

38
Q

What are the three differential diagnosis of HA

A

Anaemia + reticulocytosis
Anaemia + Acohuric Jaundice
Marrow Invasion

Basic Haemotology (1204) (16 decks)

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