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Paediatrics > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What is anaemia?

A

It is a marked decrease in haemoglobin or haematocrit below the normal values for the specific age and sex

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2
Q

What is severe anaemia?

A

<5g/dl

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3
Q

What is anaemia in children between 6 months and 5 years?

A

<11g/dl

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4
Q

What is anaemia in children between 12-15 years?

A

<12g/dl

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5
Q

What is the Hb value in a term baby and a preterm baby at birth?

A
  1. Term baby <13.5g/dl

2. Preterm <11g/dl

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6
Q

What are the causes of anaemia in the newborn?

A
  1. Impaired production
    - infections(TORCH)
    - HIV
  2. Blood loss
    - twin twin
    - cord
    - feta maternal
  3. Haemolysis
    - Rh/ABO incompatibility
    - spherocytosis
    - G6PD deficiency
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7
Q

What are the causes of anaemia in infants and pre-school children?

A
  1. Impaired production
    - infection
    - iron deficiency
    - folate deficiency
  2. Blood loss
    - platelet/coagulation abnormalities
  3. Haemolysis
    - malaria
    - spherocytosis
    - G6PD deficiency
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8
Q

What are the causes of anaemia in older children?

A
  1. Impaired production
    - iron deficiency
    - folate deficiency
    - acute leaukemia
  2. Blood loss
    - platelet, coagulation abnormalities
  3. Haemolysis
    - malaria
    - spherocytosis
    - G6PD deficiency
    - thalassemia
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9
Q

When a child presents with pallor or shock, what cause should we think of?

A

Blood loss

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10
Q

When a child presents with jaundice or hepatosplenomegaly what should we think of?

A

Haemolysis

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11
Q

What helps us differentiate the cause of anaemia between blood loss, haemolytic anaemia and hypoplastic(anaemia due to impaired production of RBC?)

A

The reticulocytes count

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12
Q

What is the development of erythrocytes(RBC)

A
  1. Heamatopoetic stem cell becomes either WBC, RBC or platelets
  2. On the path to become a red blood cell it is a erythroblast then reticulocyte then erythrocyte
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13
Q

What does a reticulocyte count of >5% mean on blood smear?

A

That the anaemia is caused by haemolysis or blood loss because the bone marrow is working extra hard to compensate for the destruction of the red blood cells

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14
Q

What does MCV mean?

A

Mean corpuscular volume(basically the sizes of the cell)

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15
Q

What is anaemia caused by impaired function(underproduction) divided into?

A
  1. Microcytic <70 fl
  2. Normocytic (70-90 fl)
  3. Macrocytic (>90 fl)
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16
Q

What are the causes of microcytic anaemia and why?

A
  1. Thalassemia
  2. Iron deficiency anaemia
  3. Anaemia of chronic disease
  4. Sideroblastic anaemia

This anaemia occurs as a result of decreased production of haemoglobin in some way
-this then leads to the cell becoming progressively smaller

17
Q

What are the causes of macrocytic anaemia?

A

> 90 fl

  • usually due to problems with DNA synthesis(basically does not become smaller)
    1. Liver disease
    2. Megaloblastic anaemia-vitamin b12 deficiency, folate deficiency
    2. Physiological-newborn
18
Q

What is iron deficiency anaemia?

A

The most common cause of anaemia in children

-usually caused by not enough consumption of iron for the first 3 months of life

19
Q

What age is the greatest risk of developing iron deficiency anaemia?

A

6 months to 3 years

20
Q

What are the clinical signs of anaemia we can expect to see in children?

A
  1. Tiredness and lethargy
  2. Tachycardia and mild ejection systolic murmur
  3. Irritability and poor feeding
  4. Pallor and koilonychia
21
Q

What type of anaemia is iron deficiency anaemia?

A

-it is a microcytic anaemia

22
Q

What is the management for iron deficiency anaemia?

A
  1. Give oral ferrous supplements of 6mg/kg/day will correct in 90% of patients
  2. We would only consider blood transfusion when <4g/dl and with cardio/pulmonary symptoms or an infection
23
Q

What is anaemia of chronic disease?

A

Chronic conditions that cause low grade anaemia due to malignancy, endocrine, hepatic disorder or infection because they cause cytokines to be released which release hepcidin in that prevents iron production

24
Q

What are the megaloblastic anaemia?

A

Folate deficiency

Vitamin B12 deficiency

25
Q

Why would vitamin B12 deficiency occur?

A
  1. Due to extreme vegetarian diet

2. Infestation of giardia infection

26
Q

What age do most children present with folate deficiency?

A

6 months-3 years and usually at risk for low birth weight and malnourished

27
Q

How can we prevent folate deficiency?

A
  1. Give folate rich foods-liver, eggs, green vegetables

2. Supplement daily with 1mg/day for 10-14 days

28
Q

What is aplastic anaemia?

A

Occurs due to bone marrow failure either by a hereditary or acquired cause and usually leads to pancytopenia

29
Q

What are the causes of aplastic anaemia?

A
  1. Infection
    - rubella, EBV, HIV
  2. Drugs
    - anti-convulsants, anti-malarials, anti-biotics
30
Q

What is the clinical features of aplastic anaemia?

A
  1. Lethargy
  2. Pallor
  3. Petechiae
  4. Easily bruised
31
Q

What is haemolytic anaemia?

A

It is the increased destruction of red blood cells causing a compensatory increase in reticulocytes causing hepatosplenomegaly, skull bossing and thinning cortices of the long bones

32
Q

What causes haemolytic anaemia?

A
  1. Hereditary conditions
    - G6PD deficiency
    - thalassemia
    - spherocytosis
    - sickle cell anaemia
  2. Acquired
    - viral infection
    - bacterial septicaemia
    - malaria
33
Q

What is hereditary spherocytosis?

A
  • the most common type of inherited haemolytic anaemia
  • caused by deficiency in spectrin and the inability of sodium to enter the red blood cell
  • the spherocytosis get trapped in the spleen so it essential that a splenectomy is done
34
Q

How can we prevent pneumococcal septicaemia when a splenectomy is done?

A
  • postpone until 5 years

- give pneumococcal vaccine

35
Q

What is thrombocytopenia?

A

-it is defined as a platelet count of below 100x 10 to the power of 9/l but is usually only symptomatic below <20x10 to the power of 9/l

36
Q

What is the symptom of thrombocytopenia?

A

Bleeding

37
Q

What are he causes of thrombocytopenia?

A
  1. Idiopathic thrombocytopenia purpura

2. Infection

Paediatrics (40 decks)

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