Normocytic/chromic: Immune, Nonimmune

Question 1

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Answer 1

Often associated with hematologic neoplasms An acquired membrane abnormality: Lacks lack Decay Accel. Factor (PIGA) which removes attatched compliment, Allows large of amounts complement to bind to the membrane, Complement-mediated hemolysis

Question 2

Paroxysmal Nocturnal Hemoglobinuria (PNH) Symptoms

Answer 2

Hemolysis occurs in paroxysms, often at night; Reddish-brown urine (Hemoglobinuria) from hemoglobin dissociating and being filtered by the kidneys Lab Findings: Polychromasia, nRBC, Schisto., +/- neutropenia, thrombocytopenia

Question 3

Paroxysmal Nocturnal Hemoglobinuria (PNH) Complications

Answer 3

Development of Fe or Folate deficiency anemia, Renal disease (Iron deposition due to intravascular hemolysis) Can progress to Aplastic Anemia, triggers can be worsened by infec., surgery, and transfusion; Platelets can cause spontaneous thrombosis

Question 4

Autoimmune hemolytic anemia (antibody mediated)

Answer 4

Associated with disorders that produce self-oriented antibodies (Malignancy, Lupus, Infection, Cold agglutinin disease, Medications)

Question 5

Alloimmune hemolytic anemia

Answer 5

Alloimmune: Immunity against the antigens of another person Hemolytic transfusion reaction: Transfusion of the wrong blood type Hemolytic disease of the newborn: Maternal antibodies destroy fetal cells

Question 6

Hemolytic uremic syndrome (HUS)

Answer 6

Often associated with severe infections: Bacterial toxins injure glomerular endothelial cells, Deposition of fibrin in renal circulation (RBC damage/destruction, Leads to acute renal failure)

Question 7

Disseminated Intravascular Coagulation (DIC)

Answer 7

Widespread activation of coagulation, Characterized by simultaneous clotting and hemorrhage, Anemia caused by: Hemorrhagic blood loss, Fibrin deposition

Question 8

Thrombotic Thrombocytopenic Purpura

Answer 8

Platelets and large forms of vWF aggregate on the microvascular endothelium occluding capillaries in organs and tissues. Neurological symptoms are more frequent, severe, and prominent in TTP than HUS. The aggregations force in Riversites through them, fragmenting the cells

Question 9

Chemical causes of Anemia

Answer 9

Immunosuppressant drugs Oxidizing medications (Methemoglobinemia) Closely related to autoimmune hemolytic anemia (Antibiotic induced hemolysis) Lead Poisoning, vemon (snake, spider, wasp)

Question 10

Physical causes of Anemia

Answer 10

Burns: Temperature disrupts structural proteins- Severe anisopoikilocytosis (Schistocytes, Microspherocytes), Severity dependent upon % of burned body surface Acute hemorrhagic blood loss: Severe GI bleeds, Gun shot wounds, Postpartum hemorrhage

Question 11

Mechanical Anemia

Answer 11

Anemia caused by traumatic injury to the RBC, from Artificial valves and vessels or DIC

Question 12

Microangiopathic hemolytic anemia (MAHA)

Answer 12

Damaged vascular endothelial cells in microcirculation, Formation of fibrin clots, RBCs are forced through fibrin strands (Fragmented or completely hemolyzed)

Question 13

Exercise-induced hemoglobinuria

Answer 13

Strenuous exercise, RBC destroyed in capillaries of the feet, Very mild to no anemia