RBC and Bleeding Disorders

Question 1

Clinical features of intravascular hemolysis

Answer 1

anemia, hemoglobinemia, hemoglobinuria, hemosiderinuria, jaundice, NO splenomegaly, brown urine due to renal hemosiderosis, serum haptoglobin depleted

Question 2

Clinical features of extravascular hemolysis

Answer 2

anemia, SPLENOMEGALY, jaundice, decr haptoglobin

Question 3

Hemolysis morphology

Answer 3

• increased numbers of erythroid precursors (normoblasts) in marrow
• prominent reticulocytosis in the PB
• hemosiderin in the spleen, liver, BM due to phagocytosis of red cells –> hemosiderosis
• If anemia severe –> EMH spleen, liver, LNs
• chronic hemolysis –> elevated biliary excretion of bilirubin promotes the formation of pigment gallstones

Question 4

hereditary spherocytosis morphology

Answer 4

-spherocytosis - small hyperchromic red cells lacking the central zone of pallor
-reticulocytosis, marrow erythroid hyperplasia, hemosiderosis, mild jaundice
-Cholelithiasis - 40-50% of adults
Moderate splenomegaly is characteristic