Thalassemia Flashcards

1
Q

Define Thalassemia

A

Decreased production of one or more globin chains

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2
Q

Which chains are in the Alpha Family category

A

Alpha and Zeta chains

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3
Q

Which chains are in the Beta Family category

A

Beta, Delta, Gamma, and Epsilon chains

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4
Q

What are the normal adult hemoglobin and their compositions?

A

Hgb A (α2β2)
Hgb A2 (α2δ2)
Hgb F (α2γ2)

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5
Q

Which Hemoglobin type is affected by β-Thalassemia?

A

Hgb A (α2β2)

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6
Q

What are the two effects seen in β-Thalassemias?

A

Total Hgb reduced, more Hgb A2 and F produced to compensate.
Accumulation of free α-chains.

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7
Q

Which Thalassemia has precipitation of free chains leading to destruction within the bone marrow?

A

β-Thalassemia Major, resulting in free α-chains precipitation and destruction in the bone marrow, and bone marrow expansion.

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8
Q

What are the 4 types of α-Thalassemia?

A

Silent Carrier (-α/αα)
Heterozygous (–/αα) or (-α/-α)
Hemoglobin H Disease (–/-α)
Hydrops Fetalis (–/–)

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9
Q

Gamma 4 tetramers are called what?

A

Hgb Barts (γ4)

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10
Q

Beta 4 tetramers are known as what?

A

Hgb H (β4)

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11
Q

Which α-Thal is clinically and appears similar to β-Thal Minor?

A

α-Thal Minor - Mild microcytic hypochromic anemia

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12
Q

Which α-Thal is clinically similar to β-Thal Major (though generally tends to be milder)?

A

Hemoglobin H disease (–/-α)

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13
Q

Which α-Thal is incompatible with life?

A

Hydrops Fetalis (–/–)

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14
Q

What do Hemoglobin H inclusions look like in a supravital stain?

A

Golf Balls!

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15
Q

How are Hgb Barts tetramers unique?

A

Extremely high affinity for O2 and will not release in fetal tissue, leads to tissue hypoxia and death.

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16
Q

How is α-Thal hard to diagnose via Hgb Electrophoresis?

A

All normal Hgb levels proportionally decreased across the board, mainly ID abnormal Hgbs such as Hgb Barts or Hgb H

17
Q

How is osmotic fragility affected by Thalassemia?

A

Decreased osmotic fragility

18
Q

How is Hgb Electrophoresis critical to the diagnosis of β-Thal?

A

Diagnosed via decreased Hgb A and increased Hgb A2 and/or Hgb F

19
Q
A