Flashcards in hemolysis Deck (52)
what is hemolysis?
premature red cell destruction
why are red cells particularly susceptible to damage? (3)
limited metabolic reserve - no mitochondria
no nucleus (no new proteins)
what metabolism do red cells depend on?
what is compensated hemolysis?
increased red cell destruction compensated by increased red cell production - Hb maintained
what is most commonly seen?
what is hemolytic anaemia?
increased rate of red cell destruction exceeding bone marrow capacity for red cell production - Hb falls
what are the consequences of hemolysis? (2)
excess red cell breakdown products eg. bilirubin
bone marrow response to haemolysis?
what stains reticulocyte ribosomal RNA?
new methylene blue
what is extravascular hemolytic anaemia?
taken up by reticuloendothelial system (spleen and liver predominantly)
what is intravascular hemolytic anaemia?
red cells destroyed within the circulation
what is the common form of hemolytic anaemia?
chronic extravascular hemolytic anaemia may present with?
splenomegaly +/- hepatomegaly
what type of. products are released in extravascular red cell destruction?
normal products in excess
what products are released in extravascular red cell destruction?
what is the presentation of unconjugated bilirubinaemia?
jaundice and gall stones
what is intravascular red cell destruction?
red cells are destroyed in the circulation spilling their contents
what products are released in intravascular red cell destruction?
what happens to hemoglobinuria?
pink urine turns black on oxidation
what type of products are released in intravascular red cell destruction?
which type of haemolysis is life threatening?
what conditions cause intravascular hemolysis? (4)
ABO incompatible blood transfusion
Severe falciparum malaria (Blackwater Fever)
Rarer still PNH,PCH
what is the most common red cell enzyme deficiency?
what conditions cause extravascular hemolysis?
essentially all other causes of hemolysis
what investigations confirm hemolytic state? (5)
FBC (+ BLOOD FILM)
Serum unconjugated bilirubin
what excludes someone haemolysing?
FBC and blood film
what do you see on the blood film if red cell membranes are damaged?
what do you see on the blood film if there is oxidative damage?
what do you see on the blood film If there is mechanical damage?
red cell fragments