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Hee-matte-ology > Haemolysis > Flashcards

Haemolysis Flashcards

1
Q

Why are red cells susceptible to damage?

A

Biconcave shape
Limited metabolic reserve and rely on glycolysis
Cant generate new proteins

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2
Q

What are the characteristics of compensated haemolysis?

A

Increased red cell destruction compensated by increased red cell production
Haemoglobin maintained

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3
Q

What are the characteristic of decompensated haemolysis?

A

Increased rate of red cell destruction
Exceeding capacity for red cell production
Hb falls

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4
Q

What are the consequences of haemolysis?

A

Erythroid hyperplasia

Excess red cell breakdown

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5
Q

What are the bone marrow responses to haemolysis?

A

Reticulocytosis

Erythroid hyperplasia

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6
Q

Are reticulocytes nucleated?

A

No

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7
Q

What do reticulocytes show?

A

Response to bleeding

Response to iron therapy

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8
Q

What stain shows reticulocytes?

A

New methylene blue stains ribosomal RNA

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9
Q

What is extravascular haemolysis?

A

Taken up by reticuloendothelial system by liver and spleen

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10
Q

What is intravascular haemolysis?

A

Red cells destroyed within the circulation

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11
Q

WHat is commoner Extravascular or intravascular haemolysis?

A

Extra

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12
Q

What is seen in extravascular haemolysis?

A

Hyperplasia at destruction site (splenomegaly, hepatomealy)

Release of protoporphyrin

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13
Q

What is seen due to release of protoporphyrin?

A 
Unconjugated bilirubinaemia
Jaundice
Gall stones
Urobilinogenuria
Normal products in excess
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14
Q

What is seen in intravascular haemolysis?

A 
Haemoglobinaemia
Methaemalbuminaemia
Haemoglobulinuria
Haemosiderinuria
Abnormal products
LIFE THREATENING
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15
Q

Which is life threatening Extra or intravascular haemolysis?

A

Intravascular

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16
Q

What can cause intravascular haemolysis?

A

ABO incompatibility
G6PD deficiency
Severe falciparum malaria
PNH PCH

17
Q

What investigations are doen for haemolysis?

A 
Confrim haemolytic state
-FBC
-Reticulocute count
-Serum Unconjugated bilirubin
-Serum haptoglobins
-Urinary urobilinogen
Identify cause:
-History and examination
Blood film 
Coombs test
18
Q

What are 4 sites of red cell defect?

A

Premature destruction of normal red cells
Abnormal cell membrane
Abnormal red cell metabolism
Abnormal haemoglobin

19
Q

What are causes of IgG autoimmune haemolysis?

A 
Idiopathic 
Autoimmune disorders
Lymphoproliferative disorders
Drugs
Infections
20
Q

What are causes of IgM autoimmune haemolysis?

A

Idiopathic
Infections
lymphoproliferative disorders

21
Q

What is the purpose of direct coombs test?

A

Identify antibody bound to own red cells

patients red cells with anti-human IgG

22
Q

What are causes of alloimmune haemolysis?

A

Immune response

Passive transfer of antibody

23
Q

What is an example of immune response in alloimmune haemolysis?

A

Haemolytic transfusion reaction
Immediate IgM intravascular
Delayed igG extravascular

24
Q

What is an example of Passive transfer of antibody?

A

Haemolytic disease of the newborn
RhD
ABO incompatibility

25
Q

What can cause mechanical red cell destruction?

A 
Disseminated intravascular coagulation
Haemolytic uraemic syndrome
TTP
Leaky valve
Infections (Malaria)
26
Q

What can cause membrane defects?

A

Liver disease
Vitamin E deficiency
Paroxysmal nocturnal haemoglobinuria

27
Q

What is Zieve’s syndrome?

A

Haemolysis
Alcoholic liiver disease
Hyperlipidaemia

28
Q

What can cause genetic red cell membrane abnormalities?

A

Reduced membrane deformabilitu
Increased transit time through spleen
Oxidant environment in spleen causing extravascular red cell destruction
Hereditary spherocytosis

29
Q

What can be deficient and lead to reduced ATP production?

A

G6PD deficiency

Metabolic process fail

30
Q

What drugs can cause oxidative damage?

A

Dapsone

Salazopyrin

31
Q

What can cause abnormal haemoglobin?

A

Sickle cell disease

Hee-matte-ology (17 decks)

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