G6Pd deficiency - Read it with me ! You will never ever forget about G6PD Deficiency.

All we need to know to excel pathology is the concepts of general Pathology and a clear mind to extrapolate. Nothing else !

G6PD - The defect in HMP pathway - Reduces NADP/NADPH - So the glutathione peroxidase cannot recycle - So we are going to have more free radical mediated damage to the cell. - This is the basic pathogenesis

With the above and with the simple concept of how a free radical damages a cell (lipid peroxidation, DNA damage, protein denaturation) - We are going to imaging the fight between a RBC and the Free radical. Lets start.
I want you to read the following lines and imagine simultaneously what you read - Your Imagination is your gift, do not lose it.

RBC vs FREE Radical

We shall take the first effect of Free radical - LIPID PEROXIDATION. The amount of free radical following an injury can be more or less, right. ?

1. When the free radicals amount is more - the RBC's membrane is totally damaged and it causes lysis inside the blood stream
2. When the free radicals amount is less - There is a partial damage to RBC membrane - Makes it a sphere - and the spherical RBC's are removed by the spleen

Next we shall take the second effect of free radical - Protein denaturation. The major protein in RBC membrane is GLOBIN, lets see what happens to it.

1. When any protein is denatured it precipitates right? (best example which i love is egg protein and denatured omlette). Same way the globin will also be precipitated. This alters the chemical nature of the product and will take up stain only by NEW METHYLENE BLUE - So it's seen as a tiny blue dot close to the membrane, ppt will settle down - giving rise to your Heinz Body
2. As i said above the protein is altered chemically, so it is not stained in Leishmann stain. So the area close to the membrane will not take up the stain so it looks clear and unstained (Imagine a RBC in a leishmann and make an arc of clear are around Heinz bodies) - What do you get, Yes it's your amazing BITE CELLS

We just finished almost the entire disease with simple imagination. And you know what you stupid MCQ's will fall under it. Now let me frame few MCQ points for you guys from above.

MCQ Points

1. Findings in smear - Spherocyte, Bite cell, Heinz bodies
2. Hemolysis - Both intra and extra vascular
3. I need free radicals to trigger hemolysis - So EPISODES seen post infection (the common cause obviously to increase free radicals)
4. Self limiting disease most of the time - Inflammation settles

Simple isn't ? Do not go behind MCQ's and do not be taken away by factual theories which is not used in practice, a consultant who is practising will not know theory - Will know only practically relevant points. !

Read the entire pathology with me with concepts which you will not forget - Conceptualise Pathology and Medicine - Subscribe here today (Early Bird - Rs.2499/- Valid till Feb 2022 - 16 months )