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Hemolytic Anemia Flashcards

1
Q

intravascular hemolysis

A

RBC ruptures in circulation

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2
Q

extravascular hemolysis

A

RBC rupture happens outside of circulation

most commonly in the spleen

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3
Q

How is heme degraded?

A

broken down in spleen to biliverdin and unconjugated bilirubin

*unconjugated bilirubin then goes to liver

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4
Q

haptoglobin in intra/extravascular hemolysis

A

intra: decreased because haptoglobin binds to free heme sites

extra: normal

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5
Q

LDH in intra/extravascular hemolysis

A

may be elevated in both

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6
Q

indirect bilirubin in intra/extravascular hemolysis

A

unconjugated bilirubin can be elevated in both

see more elevation in extravascular hemolysis

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7
Q

why does intravascular hemolysis not contributed to indirect bilirubin as much?

A

only small amounts of heme bound to haptoglobin will be recycled to bilirubin

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8
Q

Hepatosplenomegaly and lymphadenopathy indicate …

A

extravascular hemolysis

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9
Q

Urine dip for heme in intra/extravascular hemolysis

A

intra: positive for heme in urine

extra: no

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10
Q

urine dip for RBC in intra/extravascular hemolysis

A

usually negative in all hemolysis

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11
Q

DAT / direct coombs

A

indicates if hemolysis is immune-mediated or not

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12
Q

DAT vs. IAT

A

DAT tests immunoglobin or complement directly on RBC

IAT tests for red cell antibodies in patient’s serum

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13
Q

warm immune hemolytic anemia

A

+DAT

IgG mediated

most complete treatment is splenectomy

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14
Q

what can acute spherocytes indicate?

A

acute hemolytic anemia

not hereditary

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15
Q

hereditary spherocytosis vs. autoimmune anemia

A

look at DAT / coombs test

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16
Q

hereditary spherocytosis

A

spherocytes cannot traverse through spleen sinusoids in times of inflammation

RBCs are damaged in the spleen

leads to RBC breakdown / anemia

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17
Q

Inheritance pattern of G6PD def.

A

X-linked

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18
Q

Pathophysiology of G6PD Def.

A

pentose phosphate shunt cannot regenerate NADPH which is needed for formation of glutathionine

therefore, cannot overcome oxidative challenges

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19
Q

Is hereditary spherocytosis intra or extravascular?

A

extravascular

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20
Q

is autoimmune hemolysis intravascular or extravascular?

A

IgG = extravascular

IgM = intravascular

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21
Q

is G6PD def. intra or extravascular?

A

mostly intravascular

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22
Q

is sickle cell intra or extravascular?

A

both

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23
Q

is a-thalassemia intra or extravascular?

A

seems to be more extravascular

definitely intramedullary

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24
Q

what symptom is associated with elevated bilirubin?

A

jaundice

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25
what can a hypersegmented neutrophil indicate?
folate def. or B12 def
26
how can you differentiate between B12 and folate def?
only B12 def presents with neuro symptoms
27
list 5 hypoproliferative anemias
anemia of inflammation B12 + folate def lead toxicity aplastic anemia iron deficiency anemia
28
what indicates a hypoproliferative anemia?
low retic
29
Hemochromatosis
iron overload
30
how can you determine between iron def. anemia and anemia of inflammation?
anemia of inflammation will have LOW TIBC (don't want iron) iron def. anemia will have high TIBC (trying to bind the little amounts of iron)
31
what is similar about anemia of inflammation and iron deficiency anemia
both have low Fe anemia of inflammation has low Fe to limit iron in blood
32
when is ferritin low
iron deficiency anemia
33
percent iron saturation in iron def. anemia
low
34
TIBC stands for
total iron binding capacity
35
Hemoccult
tells you if you have blood in stool indicates bleeding somewhere in GI tract
36
megaloblastic anemia
very large red blood cells decrease in the number of RBCs
37
difference between megaloblastic anemia and macrocytic anemia
megaloblastic anemia is a type of macrocytic anemia megaloblastic anemia occurs during B12 def.
38
lead toxicity leads to ...
hypoproliferative anemia
39
elevated platelet indicates ...
inflammation
40
how can you treat immune-mediated hemolysis?
steroid steroids are quick acting immunosuppressants
41
Spherocytes with agglutination are seen in ...
autoimmune hemolytic anemia
42
uniform spherocytes are seen in ...
hereditary spherocytosis
43
heinz bodies and bite cells are seen in ....
G6PD def
44
schistostocytes are seen in
HUS
45
basophilic stippling is seen in
iron deficiency and lead toxicity
46
How do you calculate ANC?
WBC * (neutrophil% + band%)
47
How do you calculate ALC?
WBC * leukocyte%
48
How can you determine neutropenia?
calculate the ANC
49
List lab values for mild, moderate and high-risk neutropenia
mild: <750 ANC (cell/mm) moderate: < 500 ANC (cell/mm) high: <100 ANC (cells/mm)
50
leukocytosis
HIGH white blood cell count indicates immune response (secondary cause) can indicate leukemia (primary cause)
51
leukopenia
LOW white blood cell count can be caused by aplastic anemia can also be caused by chemotherapy and other things
52
aplastic anemia
cannot produce enough new blood cells
53
What happens at ANC < 750?
risk for bacterial infection rises
54
Bloody diarrhea can be associated with which type of anemia?
HUS *mediated by shiga-like toxin*
55
bone marrow of aplastic anemia
acellular bone marrow
56
Difference between ITP and aplastic anemia
in ITP only platelet count is low in aplastic anemia, everything is low
57
what is the only treatment for Fanconi anemia?
stem cell transplant
58
4 categories of pantocytopenia
1) loss of stem cells (fanconi, DNA damage, autoimmune) 2) marrow replacement 3) bone marrow suppression 4) peripheral destruction of cells
59
What can cause bone marrow replacement?
mylofibrosis or cancer like leukemia
60
What can cause loss of stem cells?
Fanconi, autoimmune disorder, or acquired expsoure
61
what can cause bone marrow suppression?
drugs or viruses

Fundamentals 2 (30 decks)

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