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Paediatrics > 1: Haematology - IDA > Flashcards

1: Haematology - IDA Flashcards

1
Q

What is iron deficiency anaemia

A

Low Hb, caused by iron deficiency

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2
Q

What are 5-causes of IDA in children

A
  1. Malnutrition
  2. Malabsorption
  3. Hookworm
  4. Blood loss
  5. Increase demand
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3
Q

What diet in infants can predispose to IDA

A

Prolonged consumption of breast-milk or cows-milk (which is low in iron) with late introduction of iron into diet

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4
Q

What diets in children can predispose to IDA

A

Low levels dietary iron

GI bleed

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5
Q

What can cause low levels of dietary iron

A

High milk-consumption which is low in iron

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6
Q

What can cause GI blood loss

A

Cows milk protein intolerance

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7
Q

What increases iron demand

A

Puberty

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8
Q

What causes malabsorption

A 
Coeliac disease (duodenum is where iron is absorbed) 
IBD
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9
Q

What can cause blood loss

A

Cow’s milk protein intolerance
Meckel diverticulum
Oeseophagitis

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10
Q

What intestinal parasites can cause blood loss

A

Hookworm - more common in developing world

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11
Q

What are 5 RF for IDA in children

A
  1. Pre-term
  2. Multiple pregnancy
  3. Low birth-weight
  4. Delayed introduction of solid foods 6m after
    breastfeeding
  5. Menstruation in adolescent females
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12
Q

What is a stereotypical RF for IDA in children

A

Delayed introduction of solid-foods 6m after breast feeding in females

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13
Q

Explain presentation of symptoms in IDA in children

A

Most cases of IDA are sub-clinical. Children adapt very well with IDA and it takes very low levels of Hb to be symptomatic

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14
Q

What level does Hb reach before children become symptomatic

A

6-7g/dL

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15
Q

What symptoms occur in mild-moderate IDA

A

Neurological symptoms:

  • Listlessness
  • Lifelessness
  • Irritable
  • Mood change
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16
Q

How does severe anaemia present in children

A 
Pallour 
Poor Feeding 
Breathlessness 
Lethargy 
Pica
17
Q

Explain changes in Hb during infancy

A

Hb at birth can be as high as 22 and then drop to 11 at 3-months

18
Q

Explain investigation work-up for IDA

A
  1. History
  2. FBC
  3. Iron binding studies
  4. Blood Film
19
Q

What is important in the history and why

A

Weaning history: as delayed weaning onto solid foods (6m after breast feeding) is a RF for IDA

20
Q

What is seen on FBC

A

Microcytic Hypochromic anaemia

21
Q

What defines low Hb at less than 5-years

A

<11

22
Q

What defines low Hb at less than 5-11

A

<11.5

23
Q

What defines low Hb at less than 12-14

A

<12

24
Q

What defines microcytic anaemia

A

MCV <80

25
Q

What is hypochromic anaemia

A

low MCH, low MCHC

26
Q

Explain findings of iron binding studies in IDA

A

Low ferritin

High TIBC

27
Q

Why is ferritin low in IDA

A

Due to low iron stores

28
Q

What should always be checked with ferritin and why

A

CRP. As ferritin is an acute phase reactant and can be falsely elevated in inflammation

29
Q

How will TIBC present in IDA and why

A

High. As there is low iron, there will be more available sites on Hb for iron to bind

30
Q

What are 3 findings on blood film in IDA

A
  • Pencil cells
  • Target cells
  • Anisopolikocytes
31
Q

What are anisopoikilocytes

A

RBC of different sizes and shapes

32
Q

How is IDA managed

A

5mg/Kg elemental iron per-day (Ferrous sulphate)

33
Q

How long should elemental iron be continued for

A

Give 3-months after Hb returns to normal, in order to replenish stores

34
Q

Give 3 methods to prevent IDA in children

A
  • Encourage oral iron intake: cereal, dark vegetables
  • Iron-supplementation in pre-term infants
  • Avoid prolonged milk

Paediatrics (61 decks)

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