IMMUNE HEMOLYTIC
ANEMIAS EXAM
QUESTIONS WITH
100% SOLVED
ANSWERS!!
AIHA
OCTOBER 18, 2024
EVATEE
,IMMUNE HEMOLYTIC ANEMIAS EXAM
QUESTIONS WITH 100% SOLVED ANSWERS!!
What are the three classifications of immune hemolytic anemias? Answer - 1.
AIHA (autoimmune hemolytic anemia)
2. alloimmune hemolytic anemia
3. DIHA (drug-induced hemolytic anemia)
What are the five classifications of AIHA? Answer - 1. WAIHA (warm
autoimmune hemolytic anemia)
2. CAS/CAD (cold agglutinin syndrome
3. mixed-type AIHA
4. PCH (paroxysmal cold hemoglobinuria)
Alloimmune hemolytic anemias are associated with what two medical
conditions? Answer - HDFN and HTR
Why are IgM antibodies more efficient than IgG antibodies at destroying RBCs?
Answer - because IgM antibodies bind complement (IgGs only bind
complement sometimes)
What antibodies are the most common cause of intravascular destruction of
RBCs? Answer - anti-A, anti-B, anti-A,B
What antibodies (other than ABO) are capable of causing intravascular
destruction of RBCs? Answer - anti-PP1P^k, anti-Vel
,Where does extravascular destruction chiefly occur in the body? Answer - in
the liver and spleen
What types of antibodies are responsible for extravascular destruction? Answer
- antibodies that don't activate complement (such as anti-D)
What is the rate of complement-mediated destruction of RBCs (caused by
either IgM or IgG)? Answer - rapid for about 5-10 min., then abruptly slows
due to cleavage of C3b (or stops completely if IgM)
When are autoantibodies produced? Answer - produced to self-antigens when
the immune system fails to discriminate b/w self and nonself
How are autoantibodies typically detected in patient serum? Answer - with a
positive antibody screen or a positive compatibility test
How are autoantibodies typically detected on patient RBCs? Answer - with a
positive DAT or D-typing discrepencies
Autoantibodies can mask clinically significant _________________ . Answer -
alloantibodies
Autoantibodies are often directed against _____________________ antigens.
Answer - high-incidence
WAIHA causes what percentage of all IHAs? Answer - 60-70%
In what populations does WAIHA occur? Answer - any populations (any
sex/race/age, etc.)
, WAIHA is primarily ____________________ in nature. Answer - idiopathic
What are some secondary causes of WAIHA? Answer - CLL (chronic
lymphocytic leukemia), lymphomas, SLE (systemic lupus erythematosus), viral
infections, immunodeficiencies, drug therapy
What are some symptoms of WAIHA? Answer - fatigue, pallor, shortness of
breath, splenomegaly, jaundice (due to bilirubin buildup)
In a patient with WAIHA, what do clinical findings typically show? Answer -
increased reticulocyte count, spherocytes, polychromasia, decreased
haptoglobin, hemoglobinemia, hemoglobinuria
How are spherocytes formed? Answer - macrophages in the spleen nibble bits
of IgG-coated RBC
What are reticulocytes? Answer - immature RBCs
WAIHA-causing antibodies are typically of what class? Answer - IgG
(sometimes can be IgM or IgA)
At what temperature do WAIHA-causing antibodies react optimally? Answer -
37C
Describe the specificity of WAIHA-causing antibodies. Answer - typically broad
specificity (reacts w/ all cells tested) BUT occasionally shows single (relative)
specificity directed against a portion of the Rh protein
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