- •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?
26.1.23. What disorders develop in the organism as a result of intracellular hemolysis of erythrocytes?
The increased phagocytosis of erythrocytes causes the following changes:
a) development and excreation of erythropoietins by macrophages, thus erythropoietins in the red bone marrow increases and a great number of regenerative form of erythrocytes in the peripherteal blood are produced.
b) production of great amount of billirubin that causes the development of jaundice.
c) proliferation of macrophages leading to the enlargement of spleen (cpleemnomegalia).
26.1.24. What may cause the development of acquired hemolytic anemia?
According to the reasons of the development the following types of acquired hemolytic anemia may be determinated:
I. Anemia, mediated by mechanical damage of erythrocytes.
II. Immune hemolytic anemia.
III. Toxic hemolytic anemia.
IV. Infectious hemolytic anemia.
V. Acquired membranopathy,
26.1.25. Give examples of anemia mediated by mechanical damages of erythrocytes.
1. Mechanical hemolysis of prosthetics of vessels or heart values.
2. March hemoglobinuria – traumatization of erythrocytes in the capillaries of feet during prolonged march.
3. Microangiopathic hemolytic anemia (Moshkovich syndrome) – traumatization of erythrocytes in case of their collision with the threads of fibrin. It takes place at DIC-syndrome.
26.1.26. What is immune hemolytic anemia? Name the possible causes.
Immune hemolytic anemia develops together with specific immune mechanisms. They are mediated by the interaction of humoral antibodies with antigens fixed on the surface of erythrocytes and thus is a manifestation of II type allergic reactions according to Coombs and Gell classification.
According to the causes of the development the following types of hemolytic anemia may be determinated:
1. Alloimmune hemolytic anemia. It’s causes are:
a) entrance of the antibodies from the outside against proper erythrocytes (hemolytic anemia of newborn) and b) entrance of the erythrocytes against which there are antibodies in plasma (blood transfusion in compatible with blood groups ABD or Rh).
2.Autoimmune hemolytic anemia is caused by the development of antibodies against proper erythrocytes.
It may be related with the primary changes of erythrocytes themselves (production of autoantigens) or with the changes in the immune system (cancel of immunologic tolerance, appearance of prohibited clones) of lymphocytes.
3. Gestroimmune hemolytic anemia develops to fixation of foreign antigens on the surface of erythrocytes, particularly drugs (penicillin, sulfa), viruses.
26.1.27. What is hemolytic anemia of newborn?
Hemolytic anemia of newborn develops as a result of hemolysis of fetus erythrocytes and newborn, caused by mother’s antibodies. Thre are two types of hemolytic anemia of newborn: Rh – conflict and ABO conflict.
Rh – conflict develops in cause of Rh- mother’s maternity and Rh+ fetus (usually at the second maternity). At first immunization of the mother by Rh+ erythrocytes of the fetus occurs, which may enter the mother’s organism during delivery or at some defects of placenta. The most probable is immunization during delivery, that’s why Rh- conflict occurs more often in case of the second pregnancy with Rh+ fetus. In response to the entrance of Rh+ erythrocytes to the mother’s organism antibodies against D= antigen are synthesized. These antibodies (IgG) are able to penetrate through placenta into the organism of the fetus and cause hemolysis of erythrocytes.
ABO – conflict develops in cases when mother has O (I) blood group but fetus – A (II) of B (III). Normal isoglufinines in the system ABO belong to class IgM. These antibodies do not penetrate though placenta and thus do not cause ABO – conflict.
Though 10% healthy people with O(I) blood group have antibodies against agglutinogens A and B, presented by IgG. The presence of these antibodies doesn’t depend on initial ammunization. Agglutinines IgG penetrate through the placenta and may cause hemolysis of fetus erythroctes whithh blood groups A (II), B (III). Among he firtlings hemolytic anemia as a result of ABO conflict occurs with the same rate as in children born after the second, third an following delivery in compareson with resus – conflict where the rate of hemolytic anemia increases with the increase of a number of deliveries.