alt in hematologic function Flashcards
RBC ped differences
falls for first 2-3 months
-then incr until mature levels in adolescence
WBC ped differences
highest at birth
-then declines until adolescence
most common anemia
iron deficiency
chronic blood loss from __ + ___ may cause iron deficiency anemia
- celiac
- menorrhagia
iron deficiency
dietary risk factors
- infatns not eating solids after 6 mos
- infants only fed breastmilk not fortified w iron
- infants fed cows milk too early or primarily
iron deficiency anemia
symtom
pallor
iron deficiency anemia
diagnosis
- CSC to look for low RBC, HgB, HcT
- serum testing for iron
- screening rec during infancy
ANEMIA
HgB<
11g/dL
increase dietary iron
- Fe supplements start at 2-6 months depending on risk level
- educate parents about food w Fe + vit C
- cows milk restriction
Ferrous sulfate
s/e
constipation + GI discomfort
-black colored stools are normal
Ferrous sulfate
education
- taper off once food intake is sufficient
- do NOT give w food or antacids
normocytic anemia
anemia w norm sized cells
-can be due to hemorrhage
sickle cell disease
triggers
- hypoxia
- fever
- stress
- high altitudes
- vasoconstrictoin fr cold weather
acute vaso-occlussive crisis fr sickle cell
- lasts 4-6 days
- severe pain to bones, joinds, + abdomen
- swollen joints, hands, + feet
chronic vaso-occlussive crisis fr sickle cell
- incr risk of infections
- retinal detachment or blindness
- renal failure + enuresis
- liver cirrhosis + hepatomegaly
sicle cell disease complications
1 splenic/hepatic sequestration 2 acute chest syndrome 3 aplastic crisis 4 stroke 5 sepsis 6 hyperhemolytic crisis
splenic/hepatic sequestration
excessive pooling of blood esp in spleen
-reduces circulating vol> progress to hypovolemic shock
acute chest syndrome
tachypnea dyspnea retractions decr o2 sat chest/back/ab pain cough
aplastic crisis
extreme anemia d/t decr RBC production
-usually fr viral infection
sepsis fr sickle cell
- osteomyelitis
- septic arthritis
- meningitis
thalassemias
inherited blood disorder of hgb synth
thalassemias
s/s
chronic hypoxia
- headache
- irritability
- precordial + bone pain
- exercise intolerance
- anorexia
- epistaxis
thalassemias
detection
usually detected in infancy or toddlerhood
-first s/s: pallor, FTT
hemophilia A
deficiency in factor VIII
- males
- more common
hemophilia B
deficiency of factor IX
males
hemophilia is usually not detected until..
about 6 mos of age
-as they become injured fr falling over
hemophilia
s/s
- hemarthrosis
- headache
- slurred speech
- decr LOC
hemarthrosis fr hemophilia
-bleeding into joint space esp knees, elbows, ankles
-limited ROM due to pain + swelling
»>cause deformities over time
hemophilia
lab findings
- prolonged aptt
- norm pt, fibrinogen, plt count
hemophilia
meds
- DDAVP
- factor VIII or IX concentrates
- acetaminophen for pain
DDAVP
stim release of factor VIII
-good for milk cases or before procedure that can cause bleeding
von Willebrand disease
most common hereditary bleeding disorder
deficient or malfunctioning vWF
-easy bruising, bleeds often
-ddavp prn
DIC
clotting systm abormally activated
>clot material is used up
>bleeding + hemorrhage
common cause of DIC
sepsis
DIC
therapy
platelet + factor replacement
Idiopathic Thrombocytopenic Purpura
autoantibodies bind to platelet
Idiopathic Thrombocytopenic Purpura
s/s
- multiple ecchymoses + petechiae
- mucosal bleeding inmouth/nose
Idiopathic Thrombocytopenic Purpura
dx
- decr plt count
- norm Hgb + WBC
Idiopathic Thrombocytopenic Purpura
meds
- corticosteroids
- IVIG
- IV anti-D
Idiopathic Thrombocytopenic Purpura
prognosis
20% develop a chronic disease
