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Hemolytic Anemias — Warm Autoimmune Hemolytic Anemia (wAIHA)
A 46-year-old woman presents with fatigue, jaundice, and dark urine. Exam: mild splenomegaly. Labs: Hb 7.8 g/dL, ↑reticulocytes, ↑LDH, ↑indirect bilirubin, undetectable haptoglobin. Peripheral smear: spherocytes. Direct antiglobulin test (DAT) positive for IgG.
⏱️ 210s
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🌱 Beginner Level — 0 / 60
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How to Play
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Goal: Arrange steps in the correct order before time runs out.
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Pick: Click Pick to add a step; each slot is checked against the correct pathway.
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Scoring:
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+10 for a first-try correct step
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–5 for wrong (irreversible for that slot)
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–20 if the wrong step is harmful
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–2 for using a hint
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Tiers: 🏆 Mastery · 🥇 Expert (≥80%) · 🥈 Proficient (≥60%) · 🥉 Intermediate (≥40%) · 🎖️ Novice (≥20%) · 🌱 Beginner (<20%).
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Timer: ~120s; amber at 30s, red at 10s.
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Undo: Removes a step but doesn’t restore full credit if it was missed.
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Feedback: 🎯 Correct · 🚫 Wrong · ⚠️ Harmful · 💡 Hint.
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End: ✅ Case Complete or ⌛ Time Up → summary with score, tier, mistakes, and references.
💡 Hint: Order normalized to visible steps (dataset mismatch detected).
Avoid unnecessary cold avoidance counseling here (warm AIHA)
Evaluate secondary causes (lymphoid neoplasms, SLE, drugs)
Initiate prednisone 1 mg/kg/day (or equivalent)
Transfuse least-incompatible RBCs if unstable/severely anemic
If refractory/relapsing: rituximab; consider splenectomy if appropriate
Confirm hemolysis and warm AIHA with DAT (IgG ± C3)
