Lecture 16 Chapter 22 Flashcards
What disease has intravascular hemolysis, elevated LDH, primary morphology is schistocytes, always has thrombocytopenia (<150k), increased nRBCs and polychromasia
Microangiopathic hemolytic anemia (MAHA)
Blood smear results will vary depending on severity
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)
MAHA thrombotic thrombocytopenia purpura (TTP)
TTP can cause what
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
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
MAHA hemolytic-uremic syndrome (HUS)
What bacteria affiliated with HUS produces a toxin that is absorbed by the GI tract and is going to cause damage to kidneys
E. coli H7:0157
Shiga-like toxin (Verotoxin)
What is an important sign of E. coli H7:0157? And what are some other signs
Important: bloody diarrhea
Others: abdominal pain, fever, seizures, lethargy
What disease has an increase in enzymes such as ALT, AST, LDH, low platelets, schistocytes, hemolysis signs, and is directly associated with pregnancy
MAHA hemolysis, elevated liver enzymes and low-platelet count (HELLP) syndrome
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
Disseminated intravascular coagulation (DIC)
What are the standard assays for coagulation and what do they tell you
Prothrombin time (PT)
Activated partial thromboplastin time (aPTT)
They tell you whether you are able to clot and make fibrinogen quickly and sufficiently
What results would you have in PT and aPTT for MAHA and DIC
MAHA = both normal (or very small elevation
DIC = both are elevated
What is fibrinolysis and what does it produce
Breaks down fibrin and clot
Produces d-dimers
What are The results for d-dimers and fibrinogen for DIC
D-dimer elevated
Fibrinogen decreased
Describe the diagnosis of disseminated intravascular coagulation (DIC)
Schistocytes = present
Decreased platelets and fibrinogen
Hemolysis symptoms
D-dimer, PT and aPTT elevated
Explain exercise-induced hemoglobinuria
Increase in blood pressure can cause a little bit of protein or hemoglobin in your urine
What can cause red blood cell fragments that do not have a name/classification
Heat damage such as burns
How can a burn patient’s blood smear improve within 24-48 hours
The spleen will remove the cell fragments
What can you see when a person has a prosthetic heart valve
Schistocytes
Low-grade hemolysis
Cells get damaged if they run into the value because it is not soft like normal tissue
What causes malaria
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
What is the malaria Protozoa and which species is the most dangerous
Plasmodium
P. falciparum
Where does malaria travel to first in the body
Liver cells and its going to propagate and make more of itself
Why does someone with malaria get chills and fever
The schizonts are breaking apart
How do you identify the species of malaria
Send sample for PCR
What is the most common parasitic infection that cause hemolysis
Babesia microti
Disease = babesiosis
What’s another name for babesiosis and why
Nantucket fever
Commonly found in Maine, Connecticut, and Nantucket
Comes from a tick → tick gets it from white mouse
What should you look for to differentiate between Babesia and malaria
Maltese cross = Babesia
What kinds of parasites feed on hemoglobin
Malaria
Babesia
Trypanosoma
Where do trypanosoma’s come from
Africa
Central and South America
What’s another name for T. cruzi and how is it transmitted
Chagas disease
Transmitted by kissing bug
Parasite is in fecal material
Where is T. brucei found, what is another name for it, and how is it transmitted
Central and west Africa
African sleeping sickness (person develops severe insomnia)
Can be cured with antibiotics
Transmitted by tsetse fly
