Intravascular Vs Extravascular Hemolytic Anemia; What's The ACTUAL Difference?

[@MedicosisPerfectionalis]

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[@mofe620]

Is there any video you do not have? I'm always delighted when I search for something and I see your video right at the top. Thank you so much for this.

[@anna_d5150]

Disagree with the previous comment calling for more detail. No... that's what books are for, these vids are perfect for the KISS principle ... keep it simple silly. Sometimes talking in lay terms is enough to finally get the big picture! I love these vids as is! And... Thank you so much xoxox

[@MedicosisPerfectionalis]

Thank you so much 😊 You made my day!

[@jsvicky]

Exceptional good series on RBC disorders.

[@MedicosisPerfectionalis]

Thanks for your comment...You made my day...Leukemia and Lymphoma are coming soon!

[@rafikscouser2507]

thanks you very much in our exam there was a question like this : what is the most indicated test to diagnostic intravsacular hemolysis ?? a- Transferrin b-Ceruleoplasmin c-Hemopexin d-Haptoglobin e- Alpha 1 antitrypsin the Q should be what is the most indicated test to diagnostic an Hemolysis ?!!!! thanks to answer

[@DieForScones]

Haptoglobin

[@DieForScones]

Haptoglobin

[@sishabell8474]

You're brilliant sir 🌺 Thx

[@MedicosisPerfectionalis]

My pleasure 😇

[@gayathrivenpa4051]

Thanks for your effort sir. When bone marrow works harder, more erythroid precursors with raised MCV are let into blood stream. But precursors have got less Hb compared to mature ones. Why should MCH rise then?

[@MedicosisPerfectionalis]

In what condition?

[@gayathrivenpa4051]

In conditions like hemolytic anemia either intravascular or extravascular

[@MedicosisPerfectionalis]

I am launching free audio notes on SoundCloud, I hope you'll enjoy it: soundcloud.com/medicosis

[@stefanslavov1248]

Isn't haemoglobinuria the cause of darker urine? Because UCB is insoluble so it can't get excreted through the kidneys?

[@MedicosisPerfectionalis]

Thanks for your question, let me elaborate. Whenever you have increased unconjugated bilirubin, you will have increased conjugated bilirubin, because the liver is working harder to conjugate the UCB and make it water soluble (CB), this is the actual cause of dark urine (CB), and it occurs in both Intravascular and extravascular hemolysis. If it were the Hemoglobinuria, you would get dark urine only in intravascular hemolysis, which is not the case....Hope it helps!

[@stefanslavov1248]

Thank you! I was asking because you said in the video that UCB was up therefore -> darker urine, but now I know what you meant :) Awesome videos :) Keep it up!

[@MedicosisPerfectionalis]

You’re right, I should have been clearer.....Thanks a lot!

[@jyotiverma1233]

Sir your videos are so usefull and easy to understand.. thanku so much for making it easy..👌👌👏👏

[@MedicosisPerfectionalis]

You are always welcome! Please consider sharing!

[@YamaKabiri-py3zv]

❤❤❤ an excellent classification 👏👏👏👏👏

[@basemal_hubishi1989]

Please, can we get all this information as summary in reading papar Did you have slides as pdf

[@daze8326]

Awesome! Thank you

[@MedicosisPerfectionalis]

My pleasure 😇

[@manhasadia3896]

It's difficult to understand the Words/picture, below the slide,because of the written lines. But,it's a informative discussion. Thanks.

[@sidra_]

Sorry if this question seems silly, but why is Paroxysmal nocturnal hemoglobinuria considered a hemolytic anemia due to /intrinsic/ defects, and not extrinsic? (Atleast, according to this textbook I am reading)

[@MedicosisPerfectionalis]

That’s a great question. We call hemolytic anemia intrinsic when the defect is in the RBCs. Extrinsic means it’s outside of RBC. In Paroxysmal nocturnal hemoglobinuria (PNH), the defect is in the GPI which is within the RBC...Does that make sense? Please let me know!

[@MedicosisPerfectionalis]

Don’t confuse intrinsic with intravascular, or extrinsic with extravascular...They are not the same.

[@sidra_]

@@MedicosisPerfectionalis ohhh I see! thank you so much 😅

[@malikasingh4876]

v. informative and accessibly presented

[@MedicosisPerfectionalis]

Thank you 🙏

[@hurabhaseeb]

Hey, Great Work done, I really appreciate your efforts.Which software you use to make such wonderful videos?

[@نورالهدىعباس-س5ك]

Why UCB is increased in extravascular more than in intravascular?

[@niharnayak6417]

Same question

[@infodiff]

Thank you so much. Your videos are so useful.

[@rakshiichaudhary4663]

was very informative and clear.. Thankyou.. keep it up

[@MedicosisPerfectionalis]

My pleasure 😇

[@user-Nice-Me]

تقريبا احنا مش بنروح جامعات😅 .. الشرح جميل جدا❤

[@MedicosisPerfectionalis]

Would you please help me by sharing my videos with others?

[@fatimab6064]

You are amazing and your voice is soothing 💖

[@MedicosisPerfectionalis]

Thank you so much 😊

[@ramaal-hallak2463]

Good job👌🏻

[@clancyghost3219]

Hey there ! I have doubt whether G6PD is IVH or EVH as it has bite cells which is result of splenic phagocytosed Thank you

[@Dr.Mosleh]

Excellent lecture!

[@MedicosisPerfectionalis]

Thank you so much!

[@saalshareef3358]

Why LDH and plasma HB increase more in intravascular than extravascular ??

[@MedicosisPerfectionalis]

Because in intravascular hemolysis, the RBC is destroyed in the blood stream, causing its contents (Hb and LDH) to rush to the blood instantaneously, while in extravascular hemolysis, the lysis occurs in the spleen, giving it more time to use and recycle these contents. Hope it helps!

[@saalshareef3358]

Thanks it does 🌹

[@MedicosisPerfectionalis]

Awesome!

[@nabilasheherin2511]

Thank you..

[@oyoonanees1883]

Thank u .. helpful ❤

[@MedicosisPerfectionalis]

You are so welcome!

[@yusrahasan4119]

shouldn't retic. index be greater than 2.5 in acute blood loss?

[@MedicosisPerfectionalis]

Good question...No...The bone marrow doesn’t respond that quickly...For instance, let’s say that a patient had a car accident, do you think that when they come to the hospital the reticulocyte index will be high?!!! Nope! It’s not gonna happen...It takes days to occur. Hope it helps! Good luck!

[@chllovespizza]

hi i have a question, why is extramedullary hamatopoiesis more likely to occur in thalassaemia compared to other haemolytic anaemias?

[@MedicosisPerfectionalis]

Because Beta thalassemia major has SEVERE hemolysis.

[@chllovespizza]

@@MedicosisPerfectionalis thanks!

[@BE-uq9ew]

thank you.

[@MedicosisPerfectionalis]

My pleasure 😇

[@mmh3999]

when you talk about Phagocytes, specially macrophages, you need to mention that if they are in Blood, that means they are Monocytes. So Intravascular Hemolysis, is done via Monocytes, NOT Macrophages. In tissues, Macrophages are Tissue specific, and so they have different names. Histocytes are a general name for Connective Tissue Macrophages, and that is all. Now, if you want to talk about Spleen, then the Macrophages in Spleen are called Splenic Macrophages, or RED pulp Macrophages. These are important facts to know, and mention, if you want to make useful videos for medical students. Most students are just OK with the general picture, but some of us like to watch a more comprehensive vide lecture, that helps us put things in perspective, and not have to get confused, and go on spending more time to search more details to understand what we just listened to. Your desire to make productive videos is admirable, and I am glad to see people like you are putting efforts in my education, but tuning things are also important, and I am simply letting you know how you can make your videos better. That is all! I hope this was helpful.

[@MedicosisPerfectionalis]

Thanks for your feedback...You’re right...I get it, but if I did everything in detail, I will never finish...Without generalization, there is no wisdom...I can say more words than a textbook, but it won’t be that productive. Very few people would watch 1,000 hours of hematology...not gonna happen!! But I get it, I should have said monocytes “in the blood” I totally agree with that exact part. It was a mistake on my side. Also, in one of my questions at the end of one of the videos, I told viewers to check the difference between macrophages, histiocytes, monocytes, ...etc! Again, your advice is priceless. Please let me know how else can I improve! Thanks!

[@rasolove3]

Thanks

[@MedicosisPerfectionalis]

You’re welcome 😇

[@reachtt]

Really great video (I am taking notes)! :-D

[@reachtt]

Mr., you are so awesome! ;-)

[@MedicosisPerfectionalis]

That makes me so happy!

[@MedicosisPerfectionalis]

You're so kind...Thanks!

[@AliRaza-bu5cn]

Why MCH is increased in hemolysis??

[@castonemwaniki5355]

What about heamolytic disease of the newborn,is it intravascular or extravascular

[@learnsumthing_evday]

Intravascular because complement system is involved in hemolysis

[@niharnayak6417]

Why does UCB increase more in extra than in intra?

[@sphiesethunomali8074]

What's DIC, HUS, TTP AND HELLP I can't hear u probably

[@MedicosisPerfectionalis]

DIC: Disseminated Intravascular Coagulation. TTP: Thrombotic Thrombasthenic Purpura. HUS: Hemolytic Uremic Syndrome. HELLP: Hemolytisis, Elevated Liver enzymes, Low Platelets syndrome

[@sphiesethunomali8074]

Thanks

[@MedicosisPerfectionalis]

My pleasure 😇

[@Timaamahmoud]

شرحكم رائع

[@lizaaadr]

Isso ta tão explicadinho, quem dera um video traduzido ;|

[@زينب-ح3ش6ض]

Why your voice sad or tired please don’t harm your self ❤❤❤

[@alishubbarali1772]

Haptoglobin only decreased in intravscular hemolysis 😑

[@MedicosisPerfectionalis]

Not true. It decreases in both. Check Harrison’s internal Medicine textbook.

[@alishubbarali1772]

The haptoglobin will not be reduced in extra vascular hemolysis cause there is no release of hemoglobin into the peripheral blood In Davidson’s textbook :reduced haptoglobin is a feature of intravascular hemolysis

[@MedicosisPerfectionalis]

Thanks for your comment...Which edition of Davidson are you using? I have just checked the 22nd edition... when it talks about intravascular hemolysis, it mentions that the haptoglobin will be low. But it didn’t say that the haptoglobin will always be normal and extravascular hemolysis. And the fact that haptoglobin is low and intravascular hemolysis doesn’t negate that it can also be decreased in cases of extra vascular hemolysis. Please tell me the version and the page number and I’ll gladly check that. But for now, you can check this article: emedicine.medscape.com/article/2085592-overview#a2

[@alishubbarali1772]

22nd edition page 1026 there is a box in the top of the page The only condition when Haptoglobin reduced in extra vascular hemolysis when there is very severe hemolysis this mean we don’t always look for Haptoglobin in extra vascular hemolysis It’s something related to intravascular ❤️😘

[@jeremiahbaker6396]

lol dic, ttp , hus, hellp me! lol swear medico. also hellp as we know is in preclamspia so preclasmpsia due to thrombopenic state can promote microthrombi i think, that cause intravascular microangiopathic hemolytic anemai . doing obgn this semester as well so great connections

[@shalsh6800]

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Please speak loudly.thnks

[@TheYerjustaface]

I swear Lab hemolyze's or samples

[@sshk9580]

just a constructive criticism: please change the way you talk its too slow and monotonic. other than that everything is perfect :D

[@MedicosisPerfectionalis]

Thanks for your honest feedback...Please Watch my newest videos and tell me if they are better or not...Thank you!

[@monikafilipska1182]

you can play it faster in the settings ;-) the fact that medicosis sounds so bored is actually funny to me... I like the videos

[@rizwanarehman4464]

You can increase the playback speed, it will help

[@TheYerjustaface]

Or you could just speed up the playback speed

[@Scrubsandvlogs]

A 40-year-old woman is determined to have a hemolytic anemia which of the following laboratory tests confirms him lysis as intravascular rather than extravascular? A) Decreased haptoglobin B) Increased LDH C) Positive serum free haemoglobin D) Elevated urinary urobilinogen E) Increased ferritin

[@Scrubsandvlogs]

Would this be C or D

[@TheX7mood]

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[@MedicosisPerfectionalis]

Thanks 🙏

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Plx teach in urdu

[@victoriadaza2350]

ESPAÑOL =(

[@MedicosisPerfectionalis]

???

[@Unmercey1360]

She's sad because you speak english. I'm guessing she doesn't understand the language. :(

[@MedicosisPerfectionalis]

Got you

[@MedicosisPerfectionalis]

I don’t speak Spanish, unfortunately!

[@lamazfarsi6843]

why you talk this way? every thing is perfect except ur voice

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👍😂😂😂😂

[@10ratul]

how can i learn about this boring topic if the speaker sounds so boring? .. anyways thanks for trying

[@fondaparinux2146]

he seem so bored, while recording. show some entusiasm...

[@MedicosisPerfectionalis]

It should be “he seems”...not “he seem”! Show some English skills...Joking! ☺️

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It should be enthusiasm not entusiasm

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Okay that's your view, to me, he shows enthusiasm, he even makes jokes in between the videos and the top of all , his videos are very HELPFUL. All that pushes the scale on which side?