Anaemia
Stem Cells
--- Content provided by FirstRanker.com ---
CFU-E
Hb Ist appears
-EINT, Special Stains
Bro-erythroblast (paronoamoblast)
(Pronarmblast)
--- Content provided by FirstRanker.com ---
Noumoblast
Early Normoblast - Basophilic
Hb detected. Intermediate - Polychaematophilic
Routine stains
Late - Oathochromatic.
--- Content provided by FirstRanker.com ---
Nucleus Removed
Reticulocytes - (non nucleated)
RBC maturation
PB Time. 48hrs
Reticulocytes - Reticulum like structure
--- Content provided by FirstRanker.com ---
Ribosomal RNA proteins
can be stained by Romanowsky stain (Routine stain)
1) Giemsa 3) Jenner stain
2) Leishmann 4) Weight stain.
--- Content provided by FirstRanker.com ---
Supervital stain - specific staining
Best stain - New methylene Blue > Brilliant Cresyl Blue.
Use of Romanowsky stain -
-Reticulocytes
-Howell - Jolly Bodies
--- Content provided by FirstRanker.com ---
-Basophilic stippling
-Cabot Ring
Heinzy Bodies- never stained by Romanowsky stain..!!
-methyl violet/Crystal violet stain!
Reticulocyte < Peripheral Blood
--- Content provided by FirstRanker.com ---
Bone marrow
NR- 0.5 to 1.5/ TR- Hemolytic anaemia.
VR- aplastic anaemia.
Nutritional anaemia(Fe, Vit B12)
In megloblastic anaemia mild Hemolysis, can also - Jaundice,
--- Content provided by FirstRanker.com ---
splenomegaly, Nu. RBC
B.m: Hypercellular
M/E- Ratio Reversal (normal M/E = 3/1)
Erythroblastic Hyperplasia.
B12
--- Content provided by FirstRanker.com ---
Folic acid
No DNA Synthesis nonuclear maturation.
Apoptosis (nucleated RBC)
Infants Anterior Tibia lateral parts
--- Content provided by FirstRanker.com ---
child/adults- Posterior iliac Crest
Obesity - Anterior iliac Crest
Hemolytic Anaemia
Hereditary Spherocytosis - AD/AR.
RBC membrane protein defect
--- Content provided by FirstRanker.com ---
a) Spectrin-m/abundant, m/emutation elliptocytosis.
b) Ankyrin - m/c mutant in spherocytosis
c) Band-3 (Anion Transport Protein)
d) Protein 42- Palladin.
e) Glycophorin (not associated with HS)
--- Content provided by FirstRanker.com ---
a-Spectrin mutation: Coagulate Severitary
RBC-Biconcave, Spectrin-actin interaction.
Actin
Glycophorin > Band 3
--- Content provided by FirstRanker.com ---
Glycophorin A > B > C > D:
RBC-7.5µm dia.
- Central pallor-1/3rd of diameter of RBC.
Hypochromic-CP->1/2 of dia of RBC.
Function- Provide flexibility/deformability to RBC.
--- Content provided by FirstRanker.com ---
mutation
No flexibility
damaged membrane
Surface area
Micro spherocytes (Smaller, no Central pallor)
--- Content provided by FirstRanker.com ---
Spleen (extravascular Hemolysis)
B- Splenectomy, But even after splenectomy, Spherocytes persists HS
Hemolytic Anaemia mild to moderate Severe.
Jaundice
pigmented gallstones
--- Content provided by FirstRanker.com ---
Reticulocytes 15-7 days (Transient)
Aplastic crisis
Screening Test
RBC isotonic 0.9/ NaCl.
--- Content provided by FirstRanker.com ---
Hemolysis start at 0.5% (0.48%)
Hemolysis Completed 0.3%
Hereditary Spherocytosis
Hemolysis - >0.5% (osmotic fragility)
G6PD deficiency)- XLR
--- Content provided by FirstRanker.com ---
m/c a/w - Bacterial infections
m/c Drug - primaquine > Rapson.
Java beans (favism)
malaria protective - P. falciparum
enzyme def Hb-pathies
--- Content provided by FirstRanker.com ---
G6PD deficiency Thalassemia
Pyruvate kinase deficiency HbC.
Sickle cell carrier
Duffy DR. P. vivax
negative Protective against
--- Content provided by FirstRanker.com ---
NO DR P. vivax.
NADP
NADPH
No Reducing agent Reduced glutathione.
--- Content provided by FirstRanker.com ---
Denatured globin chains Heinz cells.
Bite cells.
Paroxysmal Nocturnal Hemoglobinuria.
Urine Sample must be collected in morning
Ist void
--- Content provided by FirstRanker.com ---
mid stream
5-10%-Congenital.
Somatic mutation in stem cell - Phosphatidyl Inositol.
coded by pian Glycosyl - A gene. mutation
Anchorprotein.
--- Content provided by FirstRanker.com ---
Complement Regulatory Protein
1) CD-59 - Membrane inhibitor of Reactive lysis
2) CD. 55 - Decay accelerating factor.
3) - Co Binding protein
M/Imutation: GPI-AP.
--- Content provided by FirstRanker.com ---
Amongst, complementary Regulatory protein- CD59.
PB Pancytopenia + Hemolytic Ant Thrombosis. / - Triad
m/c Cause of death Hepatic Vein thrombosis
PEV
--- Content provided by FirstRanker.com ---
Pathogenesis- Acidic PH
Activate complement
C5-9 (MAC) generally RBC
protected against MAC
Damage to RBC by CRP
--- Content provided by FirstRanker.com ---
Scanning- Intravascular Hemolysis
HAMS test, m/I
Sucrose lysis Test.
Confirm Flow Cytometry
PNH Aplastic anaemia
--- Content provided by FirstRanker.com ---
MTDS Acute Leukaemia
Pre leukeamic Condition - PNH, MTDS, aplastic anemia
Autoimmune Hemolytic Anaemia - AIHA
Warm Cold
m/c Type Warm agglutinin Hemolysin
--- Content provided by FirstRanker.com ---
IgM IgG
Ig G1. Syphilis, mycoplasma Donath
m/c dus OLL Viral infections. Landsteiner Ab
AI disorders - SLE (against P-Ag)
--- Content provided by FirstRanker.com ---
Cold type
Drugs- Penicillin Paroxysomal
cold Hemoglobinuria.
a-methyl Dops m/c associated with viral infection
m/c- Spherocytosis * IgG P.Ag
--- Content provided by FirstRanker.com ---
RBC
AIHA. activate complement.
Hemolysis
Coombs Test
Direct Indirect
--- Content provided by FirstRanker.com ---
Ab in Abs HDN in
Surface of. in Serum: maternal Sample.
RBC Cross matching
Nousein unexpected Ab
AIHA Non-Immunogenic (in Rare blood
--- Content provided by FirstRanker.com ---
MAHA groups)
Drug induced.
-ITP (IgG platelets)
Hemolytic disease of newborn.
Coombs Test-ve: Aplastic Anemia.
--- Content provided by FirstRanker.com ---
mismatch Blood Transfusion.
in Recipient.
Embryonic Hb (Weeks 10L)
Gower I Zeta-2 Epsilon-2.
--- Content provided by FirstRanker.com ---
2) Gower II a2 e2
3) Portland I Zeta2 e2
4) Portland II Zeta2 ?2.
Sweeks
HbF a2 ?2
--- Content provided by FirstRanker.com ---
HbA a2 ß2 [HbA2 a2 d2]-minor.
Hb pathies Quantitative
Qualitative / a, ß (Quantity reduced)
Sickle cell anaemia. a-a thallassemia,
ß. chain. ß-chain ß thallasemia.
--- Content provided by FirstRanker.com ---
6th position
glutamic Valine
[polar]-ve neutral
Insoluble
-Solubility is altered
--- Content provided by FirstRanker.com ---
-Stability-normal.
ß-thallasemia
Point mutation.
missense
--- Content provided by FirstRanker.com ---
Point mutation
nonsense
Partially accepted missense a-thallasemia-Deletion.
point mutation. -loss of a chain
a-thallasemia- aa/aa
--- Content provided by FirstRanker.com ---
1a gene deletion : aa/a- : Courier
2a gene deletion: a-/a-; aa/--: Trait
3a gene deletion: a-/-- Hbz
4a gene deletion- --/-- Hb Bartz - Hydrops fetales.
ß-thallasemia.
--- Content provided by FirstRanker.com ---
Q. [21/F: Hb-59% unit of BT; Hepato splenomegaly]
T.major, T.minor, T.trait, AIHA
1) T. major: Codey A/mediterranean Anaemia.
Hb-<3g%
multiple units of BT. Iron overload.
--- Content provided by FirstRanker.com ---
CHF m/c COD
Usual-to years
Rarely reach and decade
Confam: HPL chromatography Hb. electrophoresis
HbF To confirm
--- Content provided by FirstRanker.com ---
HbA-96% HbF-30-90/
HbF-<2%.
HbA2-3.5%
Thalassemia
--- Content provided by FirstRanker.com ---
Pediatric
Hb->7g/
upto occasional Blood Transfusion
pediatric.
Adult Transfusion dependent anemias.
--- Content provided by FirstRanker.com ---
HPLC - HbF (10-30/):
3) Thalassemia minor: Pediatric/adult
9-11g%
No.H/o blood transfusion
Both HbF HbA2
--- Content provided by FirstRanker.com ---
electrophoresis
HbF- (1.1-41)-nodiagnostic
HbA2-4-8/-bondiagnostic.
P. B Microcytic Hypochromic anaemia
hoal Timinos.
--- Content provided by FirstRanker.com ---
RDW-11.5-14.5
anisocytosis
Mentzer index MCV <13 13
RBC Count
NESTROF - Best Screening method for thalassemia
--- Content provided by FirstRanker.com ---
Normal
0.3/
normally Hemolysis Complete
No lines seen
--- Content provided by FirstRanker.com ---
Hemolysis-not complete
RBC membrane Stable.
Thalassemia
Sickle cell Anaemia
Hemolysis osmotic
--- Content provided by FirstRanker.com ---
not complete fragility
Able to view lines
0.3% - Hemolysis complete
RBC-dissolved.
Normal
--- Content provided by FirstRanker.com ---
HbE
Hbs Slow movement
Cathode(-) Anode (+)
HbA -ve faster.
2 Bands Carrier - Hbs + HbA
--- Content provided by FirstRanker.com ---
only 1 Band Disease
sunder Hypoxia, Sickle cells express adhesion
molecule.
1) Vasoo.cclusive-m/c.clinical picture
CRSs hand foot Syndrome
--- Content provided by FirstRanker.com ---
b) acute chest syndrome
(respiration) Not Jusemble
3) fish mouth vertebra
M/C Cause of DIT in Sickle Cell Salmonella infections
--- Content provided by FirstRanker.com ---
4) Autosplenectomy.
PB- Diserythrocytesis.
nuclear Remnants - Howell Jolly Bodies
1) splenectomy
Aplastic Crisis Parvarus megaloblastic anaemia
--- Content provided by FirstRanker.com ---
III) Sequestration Crisis- most dangerous,
life threatening cuses
Large volume of RBC dumped within Spleen.
Dacute Painful splenic enlargement.
ii) Hypovolemia - Shock (within 4hrs)
--- Content provided by FirstRanker.com ---
patient-dye
medical emagency
Hemosiderin+ Ca2+ Fibrotic Tissue
Gamma Gandy Bodies
1) SCA
--- Content provided by FirstRanker.com ---
2) CNTL
3) Liver aucheus
1) most important factor HbS concentration
In cauter - HbA polymerization, prevents Sickling.
--- Content provided by FirstRanker.com ---
1) Fetal Hb-Sickling
Reach to adult-level (<2%)-6months.
4. year old hay episodic. HP/Jaundice since birth
- Least-likely-Sickle.cellanaemia.
ii) HBC Anaemia / Hbsc disease
--- Content provided by FirstRanker.com ---
Sickling; Hbc Removes water & Sodium from
all. FHbscendentation - Sickling
katuves of Hat - 1) padifovative retinopathy
2) Bone infarction.
Screening- Sodium metabisulphite.
--- Content provided by FirstRanker.com ---
2) Sodium dithionate.
HPLC> electrophoresis.
Megaloblastic disease
1) Vit-B-12
ii) Folic - Av.
--- Content provided by FirstRanker.com ---
Ab against intrinsic factor of Castle (Parietal alls)
Pernicious Ab against
anaemia Fundus
Adenocarcinoma in pernicious - Fundus
--- Content provided by FirstRanker.com ---
Macrocytosis
most charecteristic
microcytosis
Macrocytosis MCV 100L
diameter of RBC - >9µm.
--- Content provided by FirstRanker.com ---
Microcytic MCV <80L
diameter of RBC <6µm
met specific - Hyper Segmented neutrophils
Neutrophil Globes of neutrophil <<<
75 lobes ->15 / neutrophils: 102
--- Content provided by FirstRanker.com ---
dyserythrocytesis.
1) Howell-Jolly Bodies:
ii) Fine Basophilic stippling
iii) Cabot Ring Figure of 8
Target Cells
--- Content provided by FirstRanker.com ---
Sickle cell Anaemia
Iron deficiency Anaemia
Thalassemia frost Megaloblastic Anaemia.
charecteristic)
MCV > 100L
--- Content provided by FirstRanker.com ---
MCHC 33-37 g/dl
H.ST, megaloblastic-normal. (not charecteristic
m/c presentation fatigability, iron
Latent Iron deficiency Anaemia- Iron Stores without
--- Content provided by FirstRanker.com ---
Anemia
Hb within normal limits
Fe-absorped-Fe 2+.
SI proximal duodenum
Storage RES - BNT, liver, spleen.
--- Content provided by FirstRanker.com ---
Fe3+ B.N Peripheral Blood.
Serum ferritin/Storage Iron.
Hepcidin - master Regulator of iron metabolism
1) Iron absorption
2) Iron mobilization from storage sites
--- Content provided by FirstRanker.com ---
Fe 2+
Apex
DMTT-1
DMTT-non specific
Transporter,
--- Content provided by FirstRanker.com ---
all divalent metal ions
Hephaestin Basal Hepcidin
Fe2+
Fe 3+
Fe Transferrin
--- Content provided by FirstRanker.com ---
Carries.
Ferritin
Lab findings
earliest
--- Content provided by FirstRanker.com ---
i) Serum ferritin - most Sensitive
11) Transferrin
TIBC - normal 300-400µg/dl
Anemia of chronic disease
iv) Saturation of Transferrin (N: 22-50%
--- Content provided by FirstRanker.com ---
IDA-<16/)
v) Hepcidin-
IDA with inflammation/infection
Serum ferritin (Acute phase Reactant)
gold standard Bone marrow Biopsy)- with spacial
--- Content provided by FirstRanker.com ---
Stain (Peils Prussian blue)
for iron stores.
11) Transferrin Receptors -
TR
TR
--- Content provided by FirstRanker.com ---
TR
TR
blood
Serum Transferrin Ratio with log index of ferritin>
Serum Transferrin Receptor > Serum ferritin
--- Content provided by FirstRanker.com ---
Best investigation to diff- IDA & ACA:
1) Bone marrow with Special Stains
2) Serum Transferrin Recepts.
--- Content provided by FirstRanker.com ---
This download link is referred from the post: Medical PG Handwritten Notes 1st Year, 2nd Year, 3rd Year and 4th Year (Study Material)