269b Acquired hemolytic anemias Flashcards Preview

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Flashcards in 269b Acquired hemolytic anemias Deck (13):
1

spherocytes - more or less membrane than normal?

less - makes it a sphere

more = target cell

2

reticulocytes - stain?

methylene blue --> stains ribosomal RNA

3

LDH?

lactate dehydrogenase is released from RBCs when they are destroyed

4

autoimmune hemolysis - detection tests?

Autoimmune hemolytic anemias are usually Coombs+

Direct Coombs test—anti-Ig/compliment antibody (Coombs reagent) added to patient’s blood. RBCs agglutinate if RBCs are coated with Ig.

Indirect Coombs test—normal RBCs added to patient’s serum. If serum has anti-RBC surface Ig, RBCs agglutinate when anti-Ig antibodies (Coombs reagent) added. Used in blood bank.

5

Warm antibody hemolytic anemia - what is it? what causes it?

Warm agglutinin: IgG --> Mo in spleen eat part of RBC and leaves smaller RBC (extravascular)

chronic anemia seen in SLE, CLL, or with certain drugs (e.g., a-methyldopa, penicillin) that bind RBCs (Ab think its foreign) OR induce autoimmune inducing

(“warm weather is GGGreat”).

6

Warm antibody hemolytic anemia - lab findings?

microspherocytes
anemia
reticulocytosis
nRBCs
other signs of hemolytic anemia

7

Warm antibody hemolytic anemia - Rx?

stop drugs
folate
steroids (1st line) --I ab production
splenectomy - refractory cases

8

Cold antibody hemolytic anemia - what is it? causes?

Cold agglutinin: IgM --> polysaccharides on RBC surface --> activates complement --> acute anemia triggered by cold, usually not clinically significant; old people on hands/feet

seen in CLL, Mycoplasma pneumonia infections, or infectious mononucleosis

(“cold ice cream—yuMMM”).

9

Cold antibody hemolytic anemia - what is it? causes?

Cold agglutinin: IgM --> activates complement; acute anemia triggered by cold, usually not clinically significant

seen in CLL, Mycoplasma pneumonia infections, or infectious mononucleosis

(“cold ice cream—yuMMM”).

10

alloimmune (not own) hemolytic disease of the newborn - which antibody from mom attacks fetal RBCs? other newborn hemolysis?

IgG

ABO hemolytic disease - from differences between mom and fetus ABO; IgG crosses from mom

11

Macroangiopathic anemia - cause? RBC appearance?

Prosthetic heart valves and aortic stenosis may also cause hemolytic anemia 2° to mechanical destruction.

schistocytes/ helmet cells

12

Paroxysmal nocturnal hemoglobinuria

^ complement-mediated RBC lysis (impaired synthesis of GPI anchor for decay-accelerating factor that protects RBC membrane from complement).

Acquired mutation in a hematopoietic stem cell.

Increased incidence of acute leukemias and strange thrombotic events.

13

Acanthocyte (spur cell, spiny RBCs) - causes?

Liver disease

abetalipoproteinemia (states of cholesterol dysregulation).