Hemolytic Anemias Flashcards
Define intracorpuscular vs extracorpuscular
Intra: issue within the RBC
- hemoglobinopathies
- RBC membrane disorders
- RBC metabolic disorders
Extra: issue outside the RBC
- RBC destroyed by antibodies, mechanics, infections, toxins, etc
List some symptoms of hemolysis
- anemia (fatigue, weakness, HA)
- pallor
- jaundice
- scleral icterus
- dark urine
- splenomegaly
Which anemias are microcytic (MCV <80)
- iron deficiency
- thalassemia
- chronic inflammation
Which anemias are normocytic (MCV 80-100)
- acute bleed
- hemolysis
- chronic inflammation, CKD
Which anemias are macrocytic (MCV >100)
- vit B12/folate deficiency
- drugs/alcohol
- liver/thyroid disease
- reticulocytosis
Describe haptoglobin
scavenger of free Hgb from lysed cells which preserves iron important for RBC production
(Free Hgb is nephrotoxic)
What causes a high retic count, bilirubin, & LDH
lysed RBCs
Describe the average lifespan of a normal RBC and the RBC of someone with SCD
Normal = 120 days
SCD = 20 days
When is a transfusion indicated in an emergency situation in anemia
- acute anemia (simple transfusion to baseline Hgb)
- Acute ischemic stroke (exchange transfusion)
- Acute pain/acute chest syndrome ONLY if severe
- Acute priapism ONLY if complicated)
- multiorgan failure, acute hepatopathy, sepsis (exchange)
What can confound newborn screening of HbSS, HbSC, S-Beta & thalassemia anemias
Predominance of hemoglobin F (HbF)
- as HbF declines and HbS rises symptoms then develop
Describe the etiology & pathophysiology of sickle cell anemia
Describe the presentation of sickle cell disease & sickle cell trait
Describe the presentation of vaso-occlusive pain crisis (acute pain episode in SCD)
Describe the diagnostic testing for sickle cell anemia
Describe the treatment for sickle cell disease