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25 Cards in this Set
- Front
- Back
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What are the 4 general mechanisms of anemia?
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1. Impaired RBC production
2. Blood Loss 3. Splenic Sequestration 4. RBC Destruction (hemolysis) |
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What 3 markers are elevated in RBC hemolysis?
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1. LDH
2. Bilirubin 3. Reticulocytes |
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What is the role of haptoglobin?
What are its levels in intravascular hemolysis? |
Haptoglobin "scavenges up" free Hg
It is thus decreased (bc used up) in intravascular hemolysis |
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What are 3 unique symptoms that point to Hemolytic Anemia?
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1. Jaundice
2. Hemoglobunuria (Hg in urine) 3. Gallstone Disease |
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What are the 2 broad mechanisms of hemolytic anemia?
Which is most common? |
1. Intravascular
2. Extravascular - MOST COMMON |
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What are the 3 important intravascular hemolytic anemias?
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1. Microangiopathy (MAHA)
2. Paroxysmal nocturnal hemoglobinuria (PNH) 3. Infections |
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What are the 2 categories of Extravascular Hemolytic Anemias?
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1. Intrinsic RBC Defects
- Hereditary spherocytosis, G6PD Deficiency 2. Extracorpuscal Defects - Immune mediated, Infections |
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What is Hereditary Spherocytosis (HS)?
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Genetic defect in either ankyrin, spectrin, or band 3 that causes the RBC to become spheroidal and lose its deformability
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How is HS confirmed?
Treated? |
Confirmed via osmotic fragility test (HS cells lyse at near normal concentrations)
Treated with splenectomy |
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What do HS RBCs look like on smear?
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Hyperchomric (no area of central pallor)
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What is G6PD deficiency?
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Pt has decreased levels of glutathione, making Hg susceptible to oxidative damage
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What stucture forms in RBCs affected by G6PD deficiency?
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Heinz bodies
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What do RBCs on smear look like with G6PD deficiency?
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- "Bites" taken out of them, like pac-man
- Have heinz bodies within cells |
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What is the most common red cell enzymopathy?
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G6PD Deficiency
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When does G6PD Deficiency usually show clinical manifestations?
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1. Acute Illness
2. Certain Drugs / Chemicals 3. Fava Bean Ingestion |
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What is autoimmune hemolytic anemia?
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Immune system attacks RBCs, causes hemolytic anemia
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What are the 2 categories of autoimmune hemolytic anema?
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1. IgG mediated (warm AIHA)
2. IgM mediated (cold AIHA) |
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What is the mechanism for IgG warm mediated AIHA?
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- IgG bind RBC's
- Cleared by Fc receptors in SPLEEN |
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What is the mechanism for IgM cold mediated AIHA?
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- IgM bind RBCs
- IgM fix complement - Complement coated RBCs cleared by LIVER |
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What test is performed to test for AIHA?
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Coombs test - coombs reagent will cause RBC's to agglutinate if have AIHA
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What is drug induced hemolytic anemia?
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Same as warm AIHA (IgG), except drug induced
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What are the 3 mechanisms of drug induced Immune Hemolytic Anemia?
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1. Hapten-mediated
2. neoantigen-mediated 3. alteration of antigen |
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What is characteristic on the blood smear of Microangiopathy?
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Small, deformed RBCs = schistocytes
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What is paroxysmal noctural hemoglobinuria (PNH)?
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RBCs have defect that allows them to be destroyed by complement
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What is the mode of inheritance for G6PD?
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X-linked
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