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Hemoglobin Disorders
Question | Answer |
---|---|
What is Thalassemia? List three consequences from Thalassemia. | DIsorders resulting in underproduction of hemoglobin chains. 3 consequences: 1) Microcytic anemia, 2) Hypochromia, 3) ineffective erythropoiesis |
Two types of Thalassemia | 1 - Alpha Thalassemia 2 - Beta Thalassemia |
Three categories of Beta Thalassemia and its presentation. | 1 - Beta Thalassemia trait -> Increased HbA2 chain (A2 = alpha and delta chains) 2 - Beta Thalassemia intermedia -> Mixture of HbA2 and HbF 3 - Beta Thalassemia major = Cooley's Anemia -> main Hb is HbF (Fetal Hemoglobin) |
Signs and Symptoms of Beta Thalassemia | 1) Splenomegaly 2) Severe Anemia 3) Bone deformity 4) Organ problems (CHF) |
What do you look for in blood smear that indicates Thalassemia | 1) Target cells 2) Microcytic Anemia 3) Hypochromia |
How many genes regulate alpha chains? | 4 |
Types of Alpha Thalassemia | 1) Silent Carrier - missing 1 - normal to mild 2) Trait - missing 2 - mild anemia 3) Hb H - missing 3 - moderate anemia with Hb H (hemoglobin with 4 beta chains) 4) Hydrops Fetalis - missing 4 -Lethal in uterine -> Stillbirth |
What happens to fetus with Hydrops Fetalis? | Missing all alpha chain genes -> Gets Hb Bart's = 4 gamma chain hemoglobin -> Poor transport = tissue hypoxia -> Multiple organ failure -> Massive edema + hypoxic death |
What two diseases fall under Sickle Cell Anemia? | Homozygous Sickle Cell Anemia (SS) + Sickle Beta Thalassemia (Bo) |
When does Sickle Cell Hemoglobins depolymerize? | During de-oxygenated state |
Factors that hemoglobin polymer depend on: | 1) Transit time through microcirculation 2) MCHC - dehydration can increase depolymerization 3) Amount of HbF in the cell - more HbF leads to less depolymerized Hbs |
What does Howell Jolly Bodies indicate? | Howell Jolly Bodies are fragments of nucleus that is incompletely removed due to defect of the spleen. |
List the treatments for Sickle Cell Disease | Hydration and Pain Control, Folate, Penicillin, Hydroxyurea - increases HbF, |
What is the name of the drug used for pain prevention in SCD? | Crizanlizumab (Criz) |