- •26.1.16. What is hemolytic anemia? How is it classified?
- •26.1.17. What endoerythrocytic factors may cause the development of hemolytic anemia?
- •26.1.18. What factors (endo- or exoerythrocytic) may cause hemolysis of erythrocytes?
- •26.1.19. Name the possible causes main mechanisms of intravascular hemolysis of erythrocytes.
- •26.1.20. What factors may cause oxidative hemolysis of erythrocytes?
- •26.1.21. What disorders may develop in the organism as a result intravascular orythrocyte hemolysis?
- •26.1.22. What is intracellular erythrocyte hemolysis? What is it cause by?
- •26.1.23. What disorders develop in the organism as a result of intracellular hemolysis of erythrocytes?
- •26.1.24. What may cause the development of acquired hemolytic anemia?
- •26.1.25. Give examples of anemia mediated by mechanical damages of erythrocytes.
- •26.1.26. What is immune hemolytic anemia? Name the possible causes.
- •26.1.27. What is hemolytic anemia of newborn?
- •26.1.28. What types of antibodies may cause hemolysis of erythrocytes? What is its mechanism?
- •26.1.29. What may cause the development of toxic hemolytic anemia?
- •26.1.31. Name possible causes of the development of infectious hemolytic anemia.
- •26.1.32. What changes of characteristic for the clinical picture of peripherial blood and red bone marrow at acquired hemolytic anemia?
- •26.1.33. What may be at the basis of inherited hemolytic anemia development?
- •26.1.34. What may cause the development of increased membranopathy?
- •26.1.35. Define microspherocytory anemia of Minkovskiy–Saffar.
- •26.1.36. What may cause the development of enzymopathy?
- •26.1.37. Define glucose 6-phosphatedehydrogenase deficiency anemia
- •26.1.38. What may cause the development of inherited hemoglobinopathy?
- •26.1.39. Define sickle sell anemia
- •26.1.40. What is the essence of talassemia?
- •26.1.41. What are clinical syndromes of hemolytic anemia?
- •26.1.42. How can anemia connected with the disorders of erythropoiesis?
- •26.1.43. What is hypoplastic anemia? What is its aetiology and pathogenesis?
- •26.1.44. Describe the clinical picture of peripheral blood and red bone marrow at hypoplastic anemia
- •26.1.46. What are the syndromes of hypoplastic anemia?
- •26.1.47. What is megaloblastic anemia? Give examples.
- •26.1.48. What is the role of vitamin b12 and folic acid in hemopoiesis?
- •26.1.49. Name the main reasons of vitamin b12 deficiency in the organism.
- •26.1.50. What is the pathogenesis of disorders developed in the organism at vitamin b12 deficiency?
- •26.1.51. Describe the clinical picture of periphereal blood and red bone marrow at b12-folic acid deficiency anemia.
- •26.1.52. Determine the place of b12-folic deficiency anemia among various anemia classifications.
- •26.1.53. What are the syndromes of b12-folic acid deficiency anemia?
- •26.1.54. What is the physiological significance of iron?
- •26.1.55. How does the exchange of iron in the organism take place?
- •26.1.56. Name the possible causes of iron deficiency anemia.
- •26.1.57. What is the pathogenesis of disorders developed in the organism in relation with iron deficiency?
- •26.1.58. Give the characteristic of periphereal blood picture and red bone marrow at iron deficiency anemia
- •26.1.59. Find the place of iron deficiency anemia among various classifications of anemia
- •26.1.60. What are the signs of iron deficiency anemia?
- •26.1.61. What is iron refractory anemia? What is its aetiology and pathogenesis?
26.1-2. Hemolytic anemias.
26.1.16. What is hemolytic anemia? How is it classified?
Hemolitic anemia develops as a result of hemolysis of erythrocytes.
Classification
I. Due to the origin: 1) acquired; 2) inherited.
II. Due to the cause of hemolysis: 1) anemia conditioned by exoerythrocytic factors (extracorpuscular); 2) anemia conditioned by endoerythrocytic factors (corpuscular).
III. Due to the mechanism of hemolysis: 1) anemia with intravascular hemolysis; 2) anemia with intracercular hemolysis.
IV. Due to the clinical course: 1) acute; 2) chronic.
26.1.17. What endoerythrocytic factors may cause the development of hemolytic anemia?
The development of hemolytic anemia may be connected with three groups of erythrocyte disorders:
defects of membrane;
disorders of enzymes (enzymopathy);
changes of hemoglobin structure.
26.1.18. What factors (endo- or exoerythrocytic) may cause hemolysis of erythrocytes?
For this purpose Mollyson’s test is used in two variants.
I. Erythrocytes of a patient with hemolytic anemia are introduced to the healthy person.
Possible findings: a) anemia is endocrythrocyfic if the hemolysis of erythrocytes develops; b) anemia is exoerythrocytic is hemolysis doesn’t develop.
II. Erythrocytes of a healthy person are introduced to the patient with hemolytic anemia.
Possible findings: a) anemia is exoerythrocytic if the hemolysis of erythrocytes develops; b) anemia is endocrythrocyfic hemolysis doesn’t develop.
26.1.19. Name the possible causes main mechanisms of intravascular hemolysis of erythrocytes.
Intravascular hemolysis develops in blood vessels under the effect of factors damaging erythrocytes. There are hemolytic factors:
a) physical factors (frauma, radiation, ultrasound, temperature);
b) chemicals (hemolytic poisons);
c) biological factors (causative agents of infections, diseases, toxins, enzymes);
d) immune factors (antidodies).
Mechanisms of intravascular hemolysis.
I. Mechanical hemolysis develops as a result of mechanical disorders of erythrocyte membrane, for example in case of erythrocyte squash the vessels of a foot.
II. Osmotic hemolsis develops when osmotic pressure inside erythrocyte is higher then osmotic pressure of blood plasma. In this case water enters erythrocyte, its volume increases and finally destruction of membrane develops. The cause of osmotic hemolysis may be either decrease of osmotic pressure of medium in which erythrocytes are find or the increase of osmotic pressure of erythrocytes. The latter, as a rule. Is connected with the increase of concentration of Na ions inside erythrocytes as a result of increased permeability of the membrane or as a result of destruction of Na-K pumps.
III. Oxydative hemolysis develops as a result of free radical oxidation of lipids and proteins of plasmatic erythrocyte membrane. The result it is the increase of erythrocyte membrane permabiliti that leads to realization of osmotic mechanism of hemolysis.
IV. Defergent hemolysis is connected with the dissolution of lipid components of erythrocyte membrane by detergents. This type of hemolysis is caused by cholemic acids (cholemic syndrome), liposoluble chemical agents, some of them are toxins of bacteria.
V. Component development hemolysis is conditioned by perforation of erythrocyte membrane by active complement. Thuis mechanism is the foundation of immune hemolysis.