36. Anaemia in children Flashcards
1
Q
Anaemia pathogenesis:
A
- Reduced RBC production
- Increased RBC destruction (haemolysis)
- Blood loss
2
Q
Reduced production of RBC (common causes):
A
- Nutritional: B12, iron, folate deficiency
- Reduced intake
- Malabsorption
- Increased requirements (growth)
3
Q
Reduced production of RBC (rare causes):
A
- Bone marrow failure
- Malignancy and chemo
- Diamond blackfan anaemia
- Aplastic anaemia
4
Q
Increased destruction/ Haemolysis:
A
- Immune haemolysis
- Intracellular red cell defects (abnormal Hb, Membrane defects, enzymopathies)
- Infections
5
Q
Increased destruction - immune haemolysis
A
- Anti-Rb antibodies
- Anti-ABO antibodies
- 2ndary jaundice required photography in the 24h of life
- Maybe IVIG, blood transfusion
6
Q
Increased destruction - Intracellular red cell defects
A
- Abnormal Hb (sickle cell disease, thalassemia)
- Membrane defects (hereditary spherocytosis, hereditary elliptocytosis)
- Enzymopathies
7
Q
Intracellular red cell defects – abnormal haemoglobin:
A
- Sickle cell disease (reduced beta globin production, haemolytic anaemia, inflammation, vaso-occlusion – tissue ischaemia or infarction, splenic infarction and hyposlenism)
- Thalassemias (reduced production of globin chains, huge heterogeneity in severity, severe haemolytic anaemia with abnormal hypochromic and microcytic cells)
8
Q
Intracellular red cell defects – membrane defects:
A
- Hereditary spherocytosis (anaemia, spherocytes on blood film, splenomegaly, risk of aplastic/haemolytic/megaloblastic crisis)
- Hereditary elliptocytosis
9
Q
Intracellular red cell defects – enzymopathies:
A
- G6DP
- Pyruvate kinase deficiency
10
Q
Increased destruction/ Haemolysis:
A
- Immune haemolysis
- Intracellular red cell defects (abnormal Hb, Membrane defects, enzymopathies)
- Infections
11
Q
Increased destruction (haemolysis) – infection:
A
- Parvovirus
- Malaria
- Haemolytic Uraemic Syndrome
12
Q
Anaemia pathogenesis:
A
- Reduced RBC production
- Increased RBC destruction (haemolysis)
- Blood loss
13
Q
Blood loss causes:
A
- Gastric ulcers
- Milk intolerance
- Hereditary haemorrhagic telangiectasia
- Meckel’s diverticulum
- IBD
- Epistaxis
14
Q
Iron deficiency causes in infants:
A
- Maternal iron deficiency
- Prematurity and low birth weight
- Multiple pregnancy
- Exclusive breast feeding after 6 months
- Late/insufficient introduction of iron rich solids
- Excess cow’s milk consumption
15
Q
Iron deficiency causes in children/adolescents:
A
- Vegetarian/vegan
- GI disorders (coeliac disease, IBD, GI infection)
- Extreme athletes
- Heavy menstrual bleeding
- Chronic blood loss
