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Clin Path > Hemolytic Anemia > Flashcards

Hemolytic Anemia Flashcards

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1
Q

CBC – Usually N/N anemia, reticulocytosis

Blood - Target cells, sickle cells, NRBC’s, Howell-Jolly bodies, Pappenheimer bodies

Lab - Sickledex screening test (turbid)

90% HbS, 8% HbF, 2% HbA2, 0% HbA

HbF protective-inc with hydroxyurea

A

Sickle Cell Disease

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2
Q

CBC - usually normal

Blood – few targets, no sickles

Lab – Sickledex screening test +

52% HbA, 45% HbS, 2% HbA2, 1% HbF

A

Sickle Cell Trait

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3
Q

CBC - Usually N/N anemia, reticulocytosis

Blood – Targets, Hb C crystals

Lab – 95% HbC, 2% HbA2, 3% HbF, 0% HbA

A

Hemoglobin C Disease

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4
Q

CBC - Usually normal

Blood – Targets

Lab – 60% HbA, 37% Hb C, 2% HbA2, 1% HbF

A

Hemoglobin C Trait

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5
Q

CBC - Usually N/N

Blood – Targets, HbC crystals, sickles, hybrids

Lab – Sickledex screening test +

HBC = HbS, 2% HbF, 1% HbA2, 0% HbA

A

Hemoglobin SC Disease

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6
Q

CBC - M/H anemia MVC 50-70, nl to high RBC count

Blood – Targets, stippling

Lab – 93% HbA, 5% HbA2, 2% HbF

A

Minor Beta Thalassemia

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7
Q

CBC - M/H anemia, MCV 50-60

Blood – Targets, NRBCs, stippling, anisopoikilocytosis

A

Intermedia Beta Thalassemia

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8
Q

CBC - Marked M/H anemia

Blood –Extreme aniscopoikilocytosis, targets, NRBCs, HJ-Bodies, pappenheimer bodies, stippling

Lab – 90% HbF, 10% HbA2

A

Major Beta Thalassemia

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9
Q

CBC - Microcytic anemia (MCV-70)

Blood – poikilo, targets, stippling, polychromasia

Lab – Sickledex screening test +

80% HbS, 1-20% HbF, >3% HbA2, 0-30% HbA

A

Sickle Cell Beta Thalassemia

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10
Q

What’s seen clinically in Sickle Cell Disease?

A

Clinical - Hand-foot synd, acute splenic seq, S. pnuemoniae, H. influenza, Mycoplasma, Salmonella (osteomyelitis), Pap necrosis, CRF, neph synd, UTIs, Aplastic crisis (parvo B19), Acute chest synd, leg ulcers, liver pain, Ca bilirub stones, marrow expansion

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11
Q

What’s seen clinically in Sickle Cell Trait?

A

usually none

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12
Q

What’s seen clinically in Hemoglobin C Disease?

A

usu asymptomatic, splenomegaly, jaundice, salmonella

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13
Q

What’s seen in hemoglobin C trait?

A

asymptomatic

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14
Q

What’s seen clinically in hemoglobin SC disease?

A

Asymptomatic to intermediate between HbSS and HbAS

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15
Q

What’s seen clinically in aa/-a (silent carrier) alpha thalassemia?

A

asymptomatic, no anemia

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16
Q

What’s seen clinically in –/-a (HbH Dz) alpha thalassemia?

A

MCV 50, mod/severe anemia, splenomegaly, HbH (beta tetramers)

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17
Q

What’s seen in –/– (hydrops fetalis) alpha thalassemia?

A

Hb Bart’s (gamma tetramers), Not viable

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18
Q

What’s seen clinically in minor beta thalassemia?

A

Clinical – Usually asymptomatic, do not confuse with Fe deficiency

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19
Q

What’s seen clinically in intermedia beta thalassemia?

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A

Clinical – Symptomatic anemia (transfusions)

20
Q

What’s seen clinically in major beta thalassemia?

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A

Clinical – Transfusions, Fe overload, skeletal changes, cardiomyopathy, HSM, delayed growth

21
Q

What’s seen clinically in sickle cell beta thalassemia?

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A

Clinical – Resembles HbSS but milder, splenomegaly

22
Q

AD, Ankyrin defect (Na/K ATPase)

CBC: Inc MCHC/MCH, numerous spherocytes

Labs: Inc LDH/Ind bili, dec hapto, DAT-, osmotic fragility+, flow band

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A

Hererditary spherocytosis

23
Q

AD, Abnormal spectrin

CBC: Usually non-anemic, 4+ elliptos

Labs: Dx by history, morphology

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A

Hereditary Elliptocytosis

24
Q

AR, spectrin deficiency + defect

CBC: 4+ poikilocytosis

Labs: Inc LDH/Ind bili, dec hapto

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A

Hereditary Pyropoikilocytosis

25
AD, abn stomatin (Na/K, swelling) _CBC:_ High MCV 150, stomatos 4+ _Labs:_ Inc LDH/Ind bili, dec hapto
Hereditary Stomatocytosis
26
Stem cell disorder, dec GPI --\> dec CD55/59, complement lysis _CBC:_ N/N anemia, pancytopenia, retics \< expected _Labs:_ Inc LDH, dec hapto, hemosiderinuria, flow for CD55/59
PNH
27
Xlink, oxidative denaturation Hb _CBC:_ N/N anemia, bites cells _Labs:_ high retics, Inc LDH/Ind bili, dec hapto, Heinz body stain, fluor screen test, enzyme assay
G6PD Deficiency
28
AR, dec ATP, membrane damage/dehydration _CBC:_ N/N anemia, aniscopoikilo, echinos, NRBCs, polychromasia _Labs:_ high retics, Inc LDH/Ind bili, dec hapto, enzyme assay
Pyruvate Kinase Deficiency
29
P. Falcip - rings, Babesia - tetrads
Parasites
30
_CBC_ frags, polychromasia, dec plts
MAHA
31
dec ADAMTS13, inc Lg MW vWF, renal/CNS microthrombi, pentad young females, IgG autoAb,
TTP (MAHA)
32
Renal failure, fever, previous bloody diar, E. coli H7
HUS (MAHA)
33
Many underlying causes, endothelial damage, clots, dec factors/bleeding, low fibrinogen, high d-Dimers
DIC (MAHA)
34
OB, RUQ pain, inc LFTs, delivery
HEELP (MAHA)
35
IgG Ab, CVDs (lupus), lymphoma, drugs _CBC:_ Microspherocytes, polychromasia _Labs:_ high retics, Inc LDH/Ind bili, dec hapto, DAT+
Warm AIHA
36
IgM Ab, Viral/mycoplasma _CBC:_ RBC agglut, inaccurate values, polychromasia _Labs:_ high retics, Inc LDH/Ind bili, dec hapto, DAT+, thermal ampl test+
Cold AIHA (not PCH)
37
IgG anti-P Ab, children viral infections _CBC:_ micropspherocytes, polychromasia _Labs:_ Inc LDH/Ind bili, dec hapto, DAT+, Donath-Landsteiner test+
Cold AIHA (PCH)
38
What's seen clinically in hereditary spherocytosis?
Variable, jaundice, splenomegaly, gallstones
39
What's seen clinically in hereditary elliptocytosis?
Usually assymptomatic, splenomegaly
40
What's seen clinically in hereditary pyropoikilocytosis?
Moderate/severe anemia
41
What's seen clinically in hereditary stomatocytosis?
Variable anemia, thrombosis with splenectomy
42
What's seen clinically in PNH?
young adult, back/abd/esophageal pain, HA, dark urine (night/am), venous thromboses
43
What's seen clinically in G6PD Deficiency?
Rapid onset with exposure, Med \> AA type due to retics involved, infection, drugs, fava beans (med type)
44
What's seen clinically in pyruvate kinase deficiency?
Mild to moderately severe anemia, splenomegaly
45
What's seen clinically in warm AIHA?
splenomegaly, jaundice
46
What's seen clinically in cold AIHA (not PCH)?
CAD, Reynaud
47
What's seen clinically in cold AIHA (PCH)?
sudden fever, chills, abd/back pain, jaundice with cold exposure

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