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Flashcards in Haemolysis Deck (24):
1

What is meant by haemolytic anaemia?

Decompensated haemolysis
- Increased rate of red cell destruction exceeding bone marrow capacity for red cell production

2

List two consequences of haemolysis?

1. Erythroid hyperplasia (increased done marrow red cell production)
2. Excess red cell breakdown products such as bilirubin

3

In what two ways does the bone marrow respond to haemolysis?

1. Reticulocytosis
2. Erythroid hyperplasia

4

Where does extravascular haemolysis usually take place?

Spleen and liver

5

Where does intravascular haemolysis take place?

Within the circulation

6

In intravascular or extravascular haemolysis more common?

Extravascular

7

What is released in excess in extravascular haemolysis?

Protoporphyrin
- unconjugated bilirubin

8

In which condition would you see pink urine, which turns black when left standing?

Intravascular haemolysis due to haemoglobinuria

9

Are the products of intravscular haemolysis normal or abnormal?

Abnormal

10

What investigations would you do if you suspected haemolysis?

1. FBC and blood film
2. Reticulocyte count
3. Serum unconjugated bilirubin
4. Serum haptoglobins
5. Urinary urobilinogen

11

Are serum haptoglobins increased or decreased in someone who has haemolysis?

Decreased

12

What cells on a blood film suggest oxidative damage?

Heinz cells

13

What cells on a blood film suggest mechanical damage?

Red cell fragments

14

What types of autoimmune haemolysis are caused by IgG antibodies?

Autoimmune disorders such as SLE
Lymphoproliferative disorders such as B cell lymphoma
Penicillins

15

What types of autoimmune haemolysis are caused by IgM antibodies?

Infections (EBV)

16

What test do you do to identify IgG antibodies to red cells?

Direct Coombs Test

17

What two ways could you get alloimmune haemolysis?

1. Immune response, the antibody is produced - eg to a haemolytic transfusion reaction
2. Passive transfer of antibody as seen in haemolytic disease of the newborn, ABO incompatibility, Rh D

18

Is the immediate haemolytic transfusion reaction mediated by IgM or IgG?

IgM (intravascular)

19

Is the delayed haemolytic transfusion reaction mediated by IgM or IgG?

IgG (extravascular)

20

What three conditions can cause acquired haemolysis due to membrane defects in the red blood cells?

1. Liver disease (Zieve's syndrome)
2. Vitamin E deficiency
3. Paroxysmal Nocturnal Haemoglobinuria

21

Deficiency of which enzyme causes a failure of red blood cells to cope with oxidant stress?

Glucose 6 phosphate dehydrogenase deficiency

22

What kind of mutation causes sickle cell anaemia?

Point mutation is the beta globin chain

23

What are the haematological findings in haemolysis?

Raised unconjugated bilirubin
Decreased haptoglobin
Increased lactate dehydrogenase
Increased urobilinogen
Reticulocytosis + polychromasia

24

What % of cell of should be reticulocytes?

2%