CPHON EXAM TEST WITH CORRECT ANSWERS GRADED A+

Autoimmune Hemolytic Anemia is a group of disorders characterized by - ANSWER malfunction of the immune system where antibodies are produced against antigens on the surface of RBSs, resulting in hemolysis T/F RBC survival is proportional to the amount of antibody on the RBC surface; therefore the greater the amount of antibody the more rapidly the RBC is destroyed. - ANSWER True Intravascular Hemolysis is - - ANSWER RBC lysis in circulation - Antibodies bind to the RBC membrane therefore activating the complement cascade - damaged membrane causes increased osmotic pressure within cell and the cell bursts Extravascular hemolysis is - ANSWER occurs when complement fixation to RBC fails to activate complement cascade - the complement on the RBC surface interacts with receptors in macrophages in the lungs, liver, and spleen - RBC phagocytosis Causes of AIHA (4) - ANSWER 1. Autoimmune disorders (LUPUS) 2. Infections (hepatitis, EBV, myco pneu) 3. Drugs (peni and quinine) 4. Hematologic disorders(Evan's syndrome and paroxysmal nocturnal hemoglobinuria) Incidence of AIHA - ANSWER 1 case per 80,000 persons Clinical Symptoms of Severe AIHA - - ANSWER - pallor - jaundice - fatigue - tachycardia -hypoxia -- organ damage - splenomagaly What labs should be ordered if AIHA is suspected? - ANSWER cbc d/p, retic, peripheral smear, Coombs test, bilirubin, LDH, and haptoglobin Labs findings that suggest AIHA is possible: - ANSWER 1. Coombs direct (DAT) : + which indicates antibodies against the RBC 2. Low Hemoglobin 3. Increased Retic 4. Spherocytes, schistocytes, or erythrocyte agglutination on blood smear 5. Increased LDH 6. Decreased haptoglobin 7. Hemoglobinuria 8. Increased Unconj bilirubin Possible parts of the Treatment Plan of AIHA - ANSWER 1. Stop medication if suspected as cause 2. Prednisone 2-4 mg/kg/day 3. High Dose IVIG 4.Splenectomy 5. pRBC transfusion 6. Folic Acid supplementation 7. Plasmapheresis (b/c IgM is confind to the intravascular space) 8. Cytotoxic agents 9. Immunosuppressive agents (Cyclosporine) 10. Hormonal therapy (danazol) What are the three types of cytoxic agents that can be used for AIHA? - ANSWER 1. Antimetabolites (6-mecaptupurine, azathioprine) 2. alkylating agents (cyclophosphamide) 3. Mitotic agents (vincristine, vinblastine) T/F Cold Antibody AIHA is most common AIHA, in whcih the autoantibodies become most active and attack RBCs usually at temperatures well below normal. . - ANSWER False. 75% of cases are warm body Pathophysiology of Warm Body AIHA IgG - ANSWER is the most common antibody attaches to RBC recognized by monocyt