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YEAR 5: Haematology SM > Haem - haemolytic anaemia + anaemia generally > Flashcards

Haem - haemolytic anaemia + anaemia generally Flashcards

1
Q

Causes of extravascular haemolytic anaemia?

A

Autoimmune causes + hereditary spherocytosis

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2
Q

Features of intravascular haemolytic anaemia?

A 
Dark red urine (haemoglobinuria)
Low haptoglobin (binds free Hb)
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3
Q

Inherited causes of haemolytic anaemia

A

Membrane: spherocytosis, elliptocytosis
Enzyme: G6PD, pyruvate kinase deficiency
Hb: sickle cell, thalassemia

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4
Q

Acquired causes of haemolytic anaemia

A

Immune or non-immune
Immune: Autoimmune(hot or cold) or alloimmune
Non-immune: malaria, MECHANICAL, PNH, MAHA

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5
Q

Which test should be done to determine if haemolytic anaemia is immune or non-immune?

A

DAT test

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6
Q

Warm autoimmune haemolytic anaemia.

List 5 causes?

A 
Idiopathic - most common
Lymphoma
CLL
SLE
methyldopa
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7
Q

3 point plan re management of warm autoimmune haemolytic anaemia?

A

Steroids
Splenectomy
Immunosuppression

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8
Q

Which Ig class is implicated in warm AIHA? and in cold AIHA?

A 
Warm = IgG
Cold = IgM
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9
Q

4 causes of cold agglutinin disease?

A

Idiopathic
Lymphoma
Mycoplasma
EBV

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10
Q

Which chemotherapy drug is used for cold agglutinin disease?

A

Chlorambucil

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11
Q

Management of PNH - 3 marks

A

1) Iron/folate supplements
2) Monoclonal Abs against complement
3) Prophylactic vaccines/Abx

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12
Q

MAHA - 4 causes?

A

HUS
TTP
DIC
Preeclampsia

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13
Q

Cause of HUS? How does MAHA develop?

A

E. Coli –> toxin damages endothelial cells

Fibrin mesh forms –> mechanical damage of RBCs!

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14
Q

Classical 5 features of TTP?

A 
MAHA
Fever
renal failure
Low plts
Neuro abnormalities!!!! - not seen in HUS
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15
Q

3 features of HUS?

A

Haemolysis
Renal failure/uraemia
Thrombocytopenia

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16
Q

How are HUS and TTP linked

A

anyone with TTP has HUS (all 3 features of HUS + fever + neuro sx = TTP)

17
Q

TTP vs HUS - which one is more likely in children?

A

HUS

18
Q

How can one distinguish between DIC and TTP?

A

DIC has prolonged APTT and PT

19
Q

Paroxysmal nocturnal haemoglobinuria - key features?

A

Haemoglobinuria in the morning

  • low haptoglobin
  • high free serum Hb
  • high LDH
20
Q

What should you look for to diagnose a patient with heparin induced thrombocytopenia?

A

Heparin use lol

  • Low platelets lol
  • haemolysis
  • renal failure/uraemia

i.e. Heparin + HUS

21
Q

7 features of DIC

A 
Haemolysis
Low platelets
Renal failure/uraemia
Neuro changes
Fever
Prolonged APTT
prolonged PT
22
Q

Abnormal RBCs seen in a crisis of a pt with G6PD deficiency

A

Heinz bodies

23
Q

3 egs of when you may see pencil cells in a blood film

A

IDA
thalassemia
Pyruvate kinase deficiency

24
Q

Target cells - causes?

A

3Hs: hyposplenism, hepatic failure, haemoglobinopathies

25
Q

Spherocytes - what can cause this? other than hereditary spherocytosis duh

A

Autoimmune haemolytic anemia

26
Q

Acanthocytes - what do they look like? What can cause it?

A

Spiky RBCs. Abetalipoproteinaemia, liver disease

27
Q

What is basophilic stippling?

A

purple spots in cytoplasm of RBCs, they are rRNA remnants

28
Q

Underlying condition in basophilic RBC stippling?

A

Haemoglobinopathies

Megaloblastic anemia

29
Q

Main cause of Heinz bodies

A

G6PD DEFICIENCY

30
Q

Main cause of rouleaux

A

Myeloma

31
Q

Pelger-Huet cells - what even is it? What is the cause?

A

Hyposegmented neutrophils

Myelodysplastic syndromes

32
Q

Howell-Jolly bodies: what do they look like?

A

purple spot in the centre of an RBC

33
Q

2 major causes of howel jolly bodies

A

Hyposplenism

Megaloblastic anemia

34
Q

In IDA, which 2 measurements goes UP and why

A

Transferrin: transports iron, so when iron is low, the liver increases transferrin production to bind to as much available iron it can

TIBC

35
Q

Name of the Neuro issue which develops following B12 deficiency?

A

Subacute Combined Degeneration of the cord (SACD)
= Loss of proprioception + loss of touch + ataxia .

Spinothalamic tracts are spared!

36
Q

Pernicious anemia - which antibody is most specific for it?

A

Anti-parietal cell antibodies

37
Q

Causes of macrocytic anaemia

A

Megaloblastic: B12 and folate def

Non-megalo: RALPH =reticulocytes, alcohol, liver failure, pregnancy, hypothyroid

Other haem probs: aplastic anaemia/MDS/MPS

YEAR 5: Haematology SM (19 decks)

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