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The Missed Chain, Increased bilirubin production (excessive red cell…

- - - - infectious disease
        
        eg. HIV & Hep b
      - genetic disease
        
        sickle cell anemia & CF
      - general blood tests
        
        fasting blood glucose
  - - - based on P-value
    - - based on effect size
      - determined by physician
- - - - Red pulp
        
        RBC , macrophages
      - White pulp
        
        Proliferating B-cells
- - - - Blood disorders, surgery or injury
        
        can cause
        
        Complications
        
        Severe (Acute Immune Hemolytic Reaction, iron overload, etc)
        
        other (Allergic reactions
        , infections etc)
        
        Common (Febrile nonhemolytic reactions & Chill-rigor reactions
  - - - deferoxamine for beta thalassemia major
    - - Low ferritin can indicate IDA anemia
      - High ferritin can indicate Hemochromatosis
  - - - B12 & 9 deficiency , β Thalassemia minor & intermedia, α thalassemia minor & minima
    - - IDA
    - - B12 & 9 deficiency
  - - - Allogenic
      - Autologous
    - - Cancers
      - Beta & alpha thalassemia major
      - Sickle cell anemia & SCID
      - Aplastic anemia
    - - Stem cell (graft) failure
      - Organ damage
      - Infections
      - New cancers
- - - - Alpha
      - Beta
      - Delta
      - Gamma
    - - Hemoglobin A
        
        Alpha / Beta
      - Hemoglobin A2
        
        Alpha / Delta
      - Hemoglobin F
        
        Alpha / Gamma
  - - - RBC enters the slpeen
        
        Gets stuck in the Sinusoidal capillaries
        
        Engulfed by macrophage
        
        Heme
        
        Heme oxygenase
        
        Biliverdin
        
        1 more item...
        
        Globin
        
        Broken into amino acids
    - - Hemoglobin binds to Haptoglobin
        
        Binds to CD163 on macrophage
- - - - X-linked recessive hereditary disease
      - Deficient in G6PD enzyme which lead to intravascular hemolysis
      - ↓G6PD →↓NADPH→ ↓reduced glutathione→ oxidative injury by H2O2→ intravascular hemolysis
  - - - Hereditary spherocytosis
        
        AD Inherited defect
        
        Most commonly ankyrin, spectrin or band 3
      - Hereditary elliptocytosis
        
        Autosomal dominant disease
        
        Caused by defect in defects in the proteins (Spectrin mainly)
    - - defect of RBCs cytoskeleton-membrane tethering protein, a network of proteins that stabilizes the lipid bilayer of the red cell
  - - - Autoimmune
      - Drug-induced
      - Infections (Malaria)
      - Paroxysmal nocturnal hemoglobinuria