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Flashcards in hemolysis Deck (52)
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1

what is hemolysis?

premature red cell destruction

2

why are red cells particularly susceptible to damage? (3)

biconcave shape
limited metabolic reserve - no mitochondria
no nucleus (no new proteins)

3

what metabolism do red cells depend on?

glucose metabolism

4

what is compensated hemolysis?

increased red cell destruction compensated by increased red cell production - Hb maintained

5

what is most commonly seen?

haemolytic anaemia

6

what is hemolytic anaemia?

increased rate of red cell destruction exceeding bone marrow capacity for red cell production - Hb falls

7

what are the consequences of hemolysis? (2)

erythroid hyperplasia
excess red cell breakdown products eg. bilirubin

8

bone marrow response to haemolysis?

reticulocytosis
erythroid hyperplasia

9

what stains reticulocyte ribosomal RNA?

new methylene blue

10

what is extravascular hemolytic anaemia?

taken up by reticuloendothelial system (spleen and liver predominantly)

11

what is intravascular hemolytic anaemia?

red cells destroyed within the circulation

12

what is the common form of hemolytic anaemia?

extravascular

13

chronic extravascular hemolytic anaemia may present with?

splenomegaly +/- hepatomegaly

14

what type of. products are released in extravascular red cell destruction?

normal products in excess

15

what products are released in extravascular red cell destruction?

unconjugated bilirubinaemia
urobilinogenuria

16

what is the presentation of unconjugated bilirubinaemia?

jaundice and gall stones

17

what is intravascular red cell destruction?

red cells are destroyed in the circulation spilling their contents

18

what products are released in intravascular red cell destruction?

haemoglobinaemia
methaemalbuniaemia
haemolgobinuria
haemosiderinuria

19

what happens to hemoglobinuria?

pink urine turns black on oxidation

20

what type of products are released in intravascular red cell destruction?

abnormal products

21

which type of haemolysis is life threatening?

intravascular

22

what conditions cause intravascular hemolysis? (4)

ABO incompatible blood transfusion
G6PD deficiency
Severe falciparum malaria (Blackwater Fever)
Rarer still PNH,PCH

23

what is the most common red cell enzyme deficiency?

G6PD deficiency

24

what conditions cause extravascular hemolysis?

essentially all other causes of hemolysis

25

what investigations confirm hemolytic state? (5)

FBC (+ BLOOD FILM)
Reticulocyte count
Serum unconjugated bilirubin
Serum haptoglobins
Urinary urobilinogen

26

what excludes someone haemolysing?

FBC and blood film

27

what do you see on the blood film if red cell membranes are damaged?

spherocytes

28

what do you see on the blood film if there is oxidative damage?

Heinz bodies

29

what do you see on the blood film If there is mechanical damage?

red cell fragments

30

what is a specialist investigation for hemolysis?

direct coombs' test and others