Haemolytic anaemia and transfusion

Question 1

Components of reticuloendothelial system? In which RBCs are destroyed

Answer 1

Spleen
Liver
Bone marrow

Question 2

Change to PLASMA FREE HAEMAGLOBIN CONCENTRATION in Intra/ Extravascular haemolysis

Answer 2

Extravascular: barely increased

Intravascular: Increased

Question 3

Basic division of haemolytic anaemia? (3)

Answer 3

1. Defects within RBCs
2. Decreased structural Integrity of membrane/ cytoskeleton
3. Damage by extrinsic factors

Question 4

RBC abnormalities on blood film

Answer 4

Polychromatic RBCs (larger w RNA staining)

Nucleated RBCs

Question 5

Investigations confirming release of haemoglobin from damaged RBCs

Answer 5

• Decreased serum haptoglobins
• Presence of methaemalbuminaemia (when haptoglobins saturated)
• Haemoglobinuria and haemosiderinuria - intravascular haemolysis

Question 6

Precise diagnostic test for Hereditary spherocytosis?

Answer 6

eosin-5-maleimide (EMA) dye binding test

or

osmotic-fragility determination

Question 7

Precise diagnostic test for Thalassaemia

Answer 7

estimation of percentage of hemoglobins A 2and F

Question 8

Precise diagnostic test(s) for:

autoimmune acquired haemolytic anaemia

Answer 8

• Direct antiglobulin test
• Tests for autoantibodies in the patient’s serum
• Demonstration of thermal range of autoantibodies