Flashcards in Hematology - hemolysis Deck (11):
Patient with recurrent episodes of hemolysis, intermittent jaundice, splenomegaly, and family history of anemia – most likely diagnosis? Patient likely to develop what other pathology? Most accurate test? Treatment?
Osmotic fragility test
Folic acid and splenectomy (to stop hemolysis)
Warm/IgG hemolysis – etiologies?
#CLL or lymphoma
#Penicillin, phenytoin, rifampin, methyldopa
Warm/IgG hemolysis – Diagnosed with? Describe RBCs?
Best initial treatment? Other treatments?
Spherocytes (spleen bites off pieces with antibodies)
Glucocorticoids; splenectomy, IVIg, steroid alternates (cyclophosphamide, cyclosporine, azathioprine, mycophenolate)
Patient presents with numbness or mottling of the nose, ears, fingers. Symptoms resolve upon warming up body part – diagnosis? Test? associated with what illnesses? Treatment?
Cold agglutinin disease
Cold agglutinin titer
EBV, Waldenström, mycoplasma pneumonia
Stay warm, rituximab/immunosuppressives
Did not give this drug for cold agglutinin disease?
African American/Mediterranean man with sudden anemia and jaundice - diagnosis? Most common precipitants?
Dapsone, quinidine, sulfur drugs, primaquine, nitrofurantoin
G6PD - Best initial test? Most accurate test?
Peripheral smear for Heinz bodies and bite cells
G6PD level 1-2 months AFTER acute episode (Normal in acute episode)
Patient presents with episodic dark urine with the first urination of the day. Suspected diagnosis? Mechanism? Lab findings likely show? Most common cause of death?
Paroxysmal nocturnal and hemoglobinuria
Deficiency in Decay Accelerating Factor (complement regulatory proteins CD 55 and 59) - mild acidosis during sleep leads to hemolysis
Patient with suspected paroxysmal nocturnal hemoglobinuria – most accurate test? Treatment?
Measuring level of CD 55 and 59 (decreased) with flow cytometry
#Bone marrow transplant for a cure
#eculizumab - inactivates C-5 in the complement pathway
Thrombosis from nocturnal hemoglobinuria affects what veins most commonly?
Mesenteric and hepatic