35.3 Anaemia

Question 1

at birth what is the Hb/MCV/MCH relative to adult?

Answer 1

all higher than normal the begins to drop off

Question 2

when is the nadir for Hb/MCV/MCH

Answer 2

2 months

Question 3

2 things to looks at when you see a low haemoglobin

Answer 3

MCV

Reticulocyte count: are they producing?

Question 4

iron deficiency anaemia, if ferritin is what level = diagnostic?

Answer 4

<10ug/L

Question 5

ferritin goes up in?

Answer 5

infection
malignancy
liver disease

Question 6

how much iron to treat anaemia?

Answer 6

6mg/kg/day of elemental iron
1ml/kg/day of ferro-liquid
treatment for 3 months

Question 7

when to check for response with iron therapy?

Answer 7

1-2 weeks

Question 8

restrict milk in anaemia?

Answer 8

500ml

Question 9

how to tell if child has cow’s milk protein intolerance?

Answer 9

hopyalbuminaemic
bleeds from gut
managed by boiling cow’s milk

Question 10

when do alpha chain disorder manifest?

Answer 10

birth, persists throughout life

Question 11

when do beta chain disorder manifest?

Answer 11

3-6months persists

Question 12

when do gamma chain disorder manifest?

Answer 12

birth, declines after

Question 13

what is thalassaemia intermedia?

Answer 13

can be homozygous or variety, not requiring transfusions

Question 14

problem with transfusion dependent thalassaemia?

Answer 14

iron overload,

need chelator, daily

Question 15

what to investigate if think thalassaemia?

Answer 15

FBC
Film
HB electrophoresis/Hb studies
Ferritin

Question 16

2 main causes of megaloblastic anaemia?

Answer 16

B12 - deficiency in mother
-vegans
-missing ileum
-selective malabsorption
Folate - not as much

Question 17

why do ppl with hereditary spherocytosis get more gallstones?

Answer 17

increased breakdown of RBCs, more bilirubin, more load on liver

Question 18

hereditary spherocytosis bad complication?

Answer 18

aplastic crises secondary to parvovirus

Question 19

what happens in a G6PD attack?

Answer 19

• oxidative hemolysis
• get brown urine
• jaundice

Question 20

if G6PD is x-linked, how do girls get it?

Answer 20

• homozygous
• turner’s
• girls’ inactivate one of their Xs early on
• balance translocation

Question 21

G6PD, 2 things life-threatening?

Answer 21

• fava beans

- naphthalene

Question 22

what is diagnostic on blood film for G6PD?

Answer 22

bite and blister cells and irregularly contracted cells

Question 23

who to look for if suspect sickle cell?

Answer 23

• african
• middle eastern descent
• abdo pain and leg pain

Question 24

when to refer to paed haematologist?

Answer 24

• macrocytic anaemia
• haemoglobinopathies
• haemolytic anaemias
• anaemia+splenomegaly
• anaemia with neutropenia/thrombocytopenia

Question 25

iron supplementation in thalassemia?

Answer 25

NOPE

contraindicated, iron overload