Lecture 16 Chapter 22

Question 1

What disease has intravascular hemolysis, elevated LDH, primary morphology is schistocytes, always has thrombocytopenia (<150k), increased nRBCs and polychromasia

Answer 1

Microangiopathic hemolytic anemia (MAHA)
Blood smear results will vary depending on severity

Question 2

What disease can be hereditary and acquired, release the protein Von willebrand factor (platelets bind to site of injury causing platelet plug formation), liver produces protein ADAMTS13 (breaks down when Von willebrand opens up and chops it up, preventing activation of platelets, most commonly autoimmune (excess Von willebrand factor creates platelet formation causing nots to be made in blood vessels for no reason)

Answer 2

MAHA thrombotic thrombocytopenia purpura (TTP)

Question 3

TTP can cause what

Answer 3

Low platelets because they are forming unnecessary clots.
If there is a dot in the brain = stroke. Clot in heart = heart attack. Clot in liver = liver failure. Clot in kidneys = kidney failure

Question 4

What disease is usually associated with a GI infection, urine is turning red or brown, clots form in your glomeruli/kidneys, has low platelets, increased creatinine

Answer 4

MAHA hemolytic-uremic syndrome (HUS)

Question 5

What bacteria affiliated with HUS produces a toxin that is absorbed by the GI tract and is going to cause damage to kidneys

Answer 5

E. coli H7:0157
Shiga-like toxin (Verotoxin)

Question 6

What is an important sign of E. coli H7:0157? And what are some other signs

Answer 6

Important: bloody diarrhea
Others: abdominal pain, fever, seizures, lethargy

Question 7

What disease has an increase in enzymes such as ALT, AST, LDH, low platelets, schistocytes, hemolysis signs, and is directly associated with pregnancy

Answer 7

MAHA hemolysis, elevated liver enzymes and low-platelet count (HELLP) syndrome

Question 8

What disease is similar to MAHA, can be caused from sepsis, malignancies, cancer, pregnancy, releases procoagulants which induce coagulation, forms clots all over your body, significant drop in platelets, schistocytes, starts with clots but after a while you start bleeding all over your body

Answer 8

Disseminated intravascular coagulation (DIC)

Question 9

What are the standard assays for coagulation and what do they tell you

Answer 9

Prothrombin time (PT)
Activated partial thromboplastin time (aPTT)
They tell you whether you are able to clot and make fibrinogen quickly and sufficiently

Question 10

What results would you have in PT and aPTT for MAHA and DIC

Answer 10

MAHA = both normal (or very small elevation
DIC = both are elevated

Question 11

What is fibrinolysis and what does it produce

Answer 11

Breaks down fibrin and clot
Produces d-dimers

Question 12

What are The results for d-dimers and fibrinogen for DIC

Answer 12

D-dimer elevated
Fibrinogen decreased

Question 13

Describe the diagnosis of disseminated intravascular coagulation (DIC)

Answer 13

Schistocytes = present
Decreased platelets and fibrinogen
Hemolysis symptoms
D-dimer, PT and aPTT elevated

Question 14

Explain exercise-induced hemoglobinuria

Answer 14

Increase in blood pressure can cause a little bit of protein or hemoglobin in your urine

Question 15

What can cause red blood cell fragments that do not have a name/classification

Answer 15

Heat damage such as burns

Question 16

How can a burn patient’s blood smear improve within 24-48 hours

Answer 16

The spleen will remove the cell fragments

Question 17

What can you see when a person has a prosthetic heart valve

Answer 17

Schistocytes
Low-grade hemolysis
Cells get damaged if they run into the value because it is not soft like normal tissue

Question 18

What causes malaria

Answer 18

Disease is transmitted by mosquitos (vector) to humans and malaria is caused by a Protozoa that lives inside the gut and the salivary gland
Only female mosquitos

Question 19

What is the malaria Protozoa and which species is the most dangerous

Answer 19

Plasmodium
P. falciparum

Question 20

Where does malaria travel to first in the body

Answer 20

Liver cells and its going to propagate and make more of itself

Question 21

Why does someone with malaria get chills and fever

Answer 21

The schizonts are breaking apart

Question 22

How do you identify the species of malaria

Answer 22

Send sample for PCR

Question 23

What is the most common parasitic infection that cause hemolysis

Answer 23

Babesia microti
Disease = babesiosis

Question 24

What’s another name for babesiosis and why

Answer 24

Nantucket fever
Commonly found in Maine, Connecticut, and Nantucket
Comes from a tick → tick gets it from white mouse

Question 25

What should you look for to differentiate between Babesia and malaria

Answer 25

Maltese cross = Babesia

Question 26

What kinds of parasites feed on hemoglobin

Answer 26

Malaria
Babesia
Trypanosoma

Question 27

Where do trypanosoma’s come from

Answer 27

Africa
Central and South America

Question 28

What’s another name for T. cruzi and how is it transmitted

Answer 28

Chagas disease
Transmitted by kissing bug
Parasite is in fecal material

Question 29

Where is T. brucei found, what is another name for it, and how is it transmitted

Answer 29

Central and west Africa
African sleeping sickness (person develops severe insomnia)
Can be cured with antibiotics
Transmitted by tsetse fly