Week 2 Anemias

Question 1

Warm Autoimmune Hemolytic Anemia

Answer 1

IgG, Spleen, spherocytes. Patients Antibody their own RBCs. Macrophages nibble at the RBCs-> spherocytes. tx. steroids and splenectomy

Question 2

Cold Autoimmune Heolytic Anemia

Answer 2

IgM, Complement, Intravascular hemolysis, agglutination. Caused by infections and lymphoproliferative diseases- IgM and complement coat RBCs in colder parts of body. Complement lyses RBCs. Pallor and cyanosis in cold. Red cell agglutinates, rare sperocytes. Dx. with Dat positive. Keep pt warm.

Question 3

Sickle cell anemia

Answer 3

B chain of hemoglobin has point mutation when O2 binds and clumps up. Hemoglobin electrophoresis. Sickles clog up vessels and are fragile. Often see nucleated RBCs due to loss of spleen fx. Tx.- pain mgmt, vaccinate, blood and marrow transfusions.

Question 4

Thalassemia

Answer 4

Defect in hemoglobin, cant make enough a or beta chains. Variable severity, “Hypochromic”, microcytic anemia with increased RBC and target cells. See expansion of marrow- chipmunk face.

Question 5

Alpha Thalassemia

Answer 5

Defect in 1 of 4 alpha chains of hemoglobin. more severe because there are no other options for alpha chains, or alpha chain genes absent

Question 6

Beta thalassemia

Answer 6

Defect in beta chains of hemoglobin.

Question 7

Glucose-6phosphate dehydrogenase deficiency

Answer 7

decrease in this enzyme and oxidant exposure leads to cell lysis episodes. Is typically self limiting. Leads to RBC membrane and Hb damage. Spleen Bites out Heinz bodies.

Question 8

Microangiopathic Hemolytic Anemia

Answer 8

Physical trauma to red cells, Schistocytes (odd shapes of RBCs including triangulocytes). The RBCs are being damaged by something.

Question 9

Anemia of (acute) Blood loss

Answer 9

At first, hemoglobin is normal until fluids are regained. 2-3 days see reticulocytes.

Question 10

Anemia of Chronic Disease

Answer 10

Infections, inflammation, malifnancy. Iron metabolism disturbed. normochromic, normocytic anemia. Anemia usually mild. Find the problem.

Question 11

Anemia of Renal Disease

Answer 11

End stage renal failure (no epo production). may see echinocytes- weird looking bumpy spiky red cells.

Question 12

Anemia of Liver disease

Answer 12

Multiple causes, uncomplicated cases are rare, may see acanthocytes, targets, often see folate deficiency

Question 13

Aplastic anemia

Answer 13

Panocytopenia, empty marrow- not growing, all cells are down. Clinically see dizzyness, fatigue, recurrent infection, bleeding bruising. Tx with blood products, avoid further exposure to cause. Marrow transplant as last resort.