Flashcards in Week 2 Anemias Deck (13):
Warm Autoimmune Hemolytic Anemia
IgG, Spleen, spherocytes. Patients Antibody their own RBCs. Macrophages nibble at the RBCs-> spherocytes. tx. steroids and splenectomy
Cold Autoimmune Heolytic Anemia
IgM, Complement, Intravascular hemolysis, agglutination. Caused by infections and lymphoproliferative diseases- IgM and complement coat RBCs in colder parts of body. Complement lyses RBCs. Pallor and cyanosis in cold. Red cell agglutinates, rare sperocytes. Dx. with Dat positive. Keep pt warm.
Sickle cell anemia
B chain of hemoglobin has point mutation when O2 binds and clumps up. Hemoglobin electrophoresis. Sickles clog up vessels and are fragile. Often see nucleated RBCs due to loss of spleen fx. Tx.- pain mgmt, vaccinate, blood and marrow transfusions.
Defect in hemoglobin, cant make enough a or beta chains. Variable severity, "Hypochromic", microcytic anemia with increased RBC and target cells. See expansion of marrow- chipmunk face.
Defect in 1 of 4 alpha chains of hemoglobin. more severe because there are no other options for alpha chains, or alpha chain genes absent
Defect in beta chains of hemoglobin.
Glucose-6phosphate dehydrogenase deficiency
decrease in this enzyme and oxidant exposure leads to cell lysis episodes. Is typically self limiting. Leads to RBC membrane and Hb damage. Spleen Bites out Heinz bodies.
Microangiopathic Hemolytic Anemia
Physical trauma to red cells, Schistocytes (odd shapes of RBCs including triangulocytes). The RBCs are being damaged by something.
Anemia of (acute) Blood loss
At first, hemoglobin is normal until fluids are regained. 2-3 days see reticulocytes.
Anemia of Chronic Disease
Infections, inflammation, malifnancy. Iron metabolism disturbed. normochromic, normocytic anemia. Anemia usually mild. Find the problem.
Anemia of Renal Disease
End stage renal failure (no epo production). may see echinocytes- weird looking bumpy spiky red cells.
Anemia of Liver disease
Multiple causes, uncomplicated cases are rare, may see acanthocytes, targets, often see folate deficiency