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43 Cards in this Set
- Front
- Back
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What are the 2 classifications of Hemolytic Anemias |
Intracorpuscular defects Extracorpuscular defects |
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RBC membrane defects Enzyme deficiencies Hemoglobinopathies Thalassemias Is the Intracorpuscular or Extracorpuscular Is it inherited or Acquired |
Intracorpuscular defect Inherited |
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Paroxysmal nocturnal hemoglobinuria Is the Intracorpuscular or Extracorpuscular Is it inherited or Acquired |
Intracorpuscular defect Aquired |
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Immune HA Nonimmune HA Is the Intracorpuscular or Extracorpuscular |
Extracorpuscular |
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Infections, Mechanical causes, Chemical/physical agents, Acquired membrane disorder Immune HA or NonImmune HA |
NonImmune HA |
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Alloimmune Autoimmune (Warm, Cold autoagglutinins) Drug induced Immune HA or Nonimmune HA |
Immune HA |
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Immune hemolytic anemia has a positive or negative Coombs test |
Positive |
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Hemogloinemia and Hemoglobinuria can be found in |
Intravascular |
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Spherocytosis can be found in which hemolysis |
Extravascular |
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Immune HA that occurs when the body attacks foreign things Ex: Transfusion Rxn, Pregnancy, HDFN, and Organ transplants |
Alloimmune |
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Immune HA where Ab attacks self AG Ex: Warm AIHA, Cold aggultin (IgM class), Paroxysmal Cold hemoglobinuria, Drug induced, Mixed warm and cold |
Autoimmune |
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Immune HA is DAT positive or negative |
positive |
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In the mixed autoimmune HA: both warm reacting Ig___ autoAb and cold reacting Ig___ autoAb DAT detects both _____ and _____ |
warm= IgG cold= IgM DAT detects: C3 and IgG |
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Drug absorption (hapten) DAT is typically postivie or negative |
positive |
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Accounts for 16-30% of AIHA cases Usually IgG with C' activation ~most Ab react with I/H Ags Mostly in older adults |
Cold AIHA |
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Severity of Cold AIHA is related to |
thermal range of Ab |
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2 Types of Cold AIHA |
Idiopathic CAD Secondary CAD |
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This Cold AIHA is: usually chronic Ab involved is usually monoclononal IgM/kappa, Autoanti-I specificity Often linked to lymphoproliferative disorder |
Idiopathic CAD |
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Associated with infectious disease ~50% M. pneumoniae Secondary to lymphoproliferativve disorder ~usually chronic |
Secondary CAD |
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Lab findings of this disease are: Falsely decr RBC Falsely incr MCV Mild to moderate anemia ~normochromic/normocytic ~Polychromasia, spherocytes, clumps of RBCs ~NRBCs, erthrophagocytosis BM: Normoblastic hyperplasia |
Cold AIHA |
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rare autoimmune hemolytic disorder can occur at any age Massive intermittent acute hemolysis and hemoglobinuria Accounts for 30-40% fo all AIHA children ~mostly under 5y |
PCH |
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When do you do saline replacement 1:5 dilution with saline and is incubated for 30 min, then repeat the prev Cold AIHA sample |
when MCHC greatly increased |
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Biphasic C' fixing IgG antiAb ~Donath Landsteiner antiAb ~binds to RBC at low temps --> activates C' |
PCH Paroxysmal Cold Hemoglobinuria |
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In PCH, what happens at 37C |
Ab detaches RBC lysed by C' activation |
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Lab findings: Neutropenia, neutrophil shift to left Reticulocytopenia, spherocytes Incr serum bilirubin, BUN, LD Decr C', haptoglobin Erythrophagocytosis |
PCH |
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Hemolytic process cuased by microcirculatory lesions that causes: ~damage to endothelial linging of the small vessels ~Deposition of platelets and fibrin in microvasulature |
Hemolytic Uremic Syndrome |
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PT, APTT nrmal Proteinuria, hematuria, pyuria Incr in BUN, creatinine hyokalemia, hypoatermia Hemoglobinema, hemoglobinuria Incr bilirubin, LD Decr haptoglobin |
Hemolytic Uremic Syndrome |
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What are disorders associated with MAHA |
DIC TTP HUS |
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Mutisystem disorder ~RBC fragmentation, thrombocytopenia, acute nephropathy 2 groups: D + HUS,, D- HUS |
Hemolytic Uremic Syndrome |
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Pathophysiology of Hemolytic Uremic syndrome |
E. Coli 0157 |
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in this group there is: bloody diarrhea Acute renal afilure Chronic renal insufficiency High in age 0-2 |
D+ HUS |
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non-diarrhea associated seen in both children and adults more likely to be asociated with recurring disease than the other group of Hemolytic uremic syndrome |
D- HUS |
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compsoed of platelets and unusually large forms of VWF multimers occlude capillaries and arterioles in organs (kidneys, heart, brain, pancreas) |
Microthrombi ass with Thrombotic Throbocytopenic Purpura |
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Thrombotic Thrombocytopenic Purpura has a def in _________ which is a protease that cleaves large VWF multimers |
ADAMTS13 |
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Lab findings: Normocytic, normochromic Polychromasia, NRBC 2+-3+ shistocytes Leukocytosis with left shift Sever thromobctypenia |
TTP |
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Normal coag is altered by Bacterial sepsis, neoplasms, immunologic disorder or trama Damage to endothelial ling of vessels ~deposition of fibrin (RBC get tangled in it) |
DIC |
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Prologned PT, APTT, IT Incre D-dimer, FDPs Decr fibrinogen |
DIC |
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associated with strnous exercise transient hemolysis usually no anemia no shistocytes Fe def can occur |
Excercise-Induced Hemogloninuria (March Hemoglobinuria) |
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What antagonists cause HA |
Intracellular infections ~Malaria, Babesia Extracellular infections ~CLostridiumperfringes, Bartonella bacilliformis |
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mild normocytic, normochromic anemia extravascular destruction of parasitized erythrocytes ~Black water fever (massive acuteintravasuclar hemolysis) |
Malarial parasites |
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protozoan infection (intracellular ring-like strucutes) Extravascular hemolysis Mild to moderate anemia Incr retics incr liver enzymes, bilirubin |
Babesiosis |
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Pleomorphic organism transmitted by blood sucking arthropods or scratch/bite from a mammal (cat) Infected RBCs and endothelilal cells |
Bartonellosis (Bartonella bacilliformis) |
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Normal flora of GI tract Transient bacteremia or life-threatining produce potentexotoxins that affect RBC membrane Rapid, massive, intravascular hemolysis DIC, Neutroopenia, Thrombocytopenia, Neutropillia |
Clostridium perfringens |
