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Year 2 Hematology > Anemia in childhood > Flashcards

Anemia in childhood Flashcards

1
Q

anemia

A

decreased oxygen carrying potential to support metabolic needs as a result of

reduction in RBC number
reduction in Hb
reduction in RBC volume

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2
Q

how is Hb assayed?

A

direct spectrophotometry

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3
Q

how is Hct assayed?

A

determined by RBC count and MCV

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4
Q

MCHC greater than 35 indicates what condition?

A

spherocytosis

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5
Q

what are the two ways anemia is classified?

A
  1. size of RBC

2. increased destruction vs. decreased production

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6
Q

microcytic hypochromic anemia could be due to what causes?

A
  1. iron deficiency
  2. lead toxicity
  3. thalassemia
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7
Q

macrocytic hyperchromic anemia could be due to what causes?

A
  1. B12 deficiency

2. folate deficiency

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8
Q

goat milk is low in what nutrient?

A

folate

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9
Q

what are differentials for normocytic anemia with decreased reticulocytes?

A
  1. diamond blackfan
  2. transient erythroblastopenia of childhood
  3. parvovirus
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10
Q

what are the differentials for normocytic anemia with increased reticulocytes?

A
  1. blood loss
  2. ABO / Rh incompatibility (positive Coomb’s - immune)
  3. membrane defect, hemoglobinopathy, G6PD, pyruvate kinase defect (negative Coomb’s - non immune)
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11
Q

what are the common causes of iron deficiency anemia in childhood?

A
  1. excessive milk intake
  2. early milk intake prior to 1 year
  3. blood loss
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12
Q

what are the lab values for iron deficiency anemia in childhood?

A
  1. MCV decreased
  2. RDW increased
  3. ferritin decreased
  4. transferrin decreased
  5. serum iron decreased
  6. TIBC increased
  7. reticulocytes normal to increased
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13
Q

cow milk should be avoided in children until what age?

A

12 months

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14
Q

how does transient erythroblastopenia of childhood present?

A
  1. decreased production of RBCs in bone marrow
  2. moderate to severe anemia
  3. MCV normal
  4. reticulocyte count usually decreased
  5. may follow a viral illness
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15
Q

how does diamond blackfan anemia present?

A
  1. almost always under 1 year of age
  2. moderate to severe anemia
  3. MCV normal or sometimes increased
  4. reticulocytes decreased
  5. Hb F increased
  6. 25% physical findings - snub nose, wide eyes, hand/finger defects, short stature
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16
Q

what is the cause for congenital pure red cell dysplasia (diamond blackfan)?

A

ribosomal protein synthesis is abnormal - causes lack of progenitor cells

17
Q

what is the treatment for TEC?

A

supportive only unless there is CV instability, in which case transfuse

18
Q

what is the treatment for DBA?

A

prednisone, transfusions

19
Q

what is the treatment for iron deficiency anemia?

A

6mg/kg/day of oral elemental iron until Hb is normal, then additional two months to replete iron stores

20
Q

what are the three sickle cell crises?

A
  1. vaso-occlusive
  2. aplastic
  3. hemolytic / splenic sequestration
21
Q

vaso-occlusive sickle cell crisis is often precipitated by what conditions?

A
  1. infection
  2. acidosis
  3. dehydration
  4. hypoxia
22
Q

what is the pathology associated with vaso-occlusive sickle cell crisis?

A

sickled RBCs block small vessels causing bone and tissue infarctions, splenic RBC trapping, stroke, and PAIN

23
Q

what are the treatments for vaso-occlusive sickle cell crisis?

A
  1. supportive
  2. pain management
  3. hydroxyurea
24
Q

why does hydroxyurea help treat vaso-occlusive sickle cell crisis?

A

increases Hb F

25
Q

what is often the causative agent for aplastic sickle cell crisis?

A

parvovirus B19

26
Q

what is the pathology associated with aplastic sickle cell crisis?

A
  1. slow down in RBC production
  2. acute drop in Hct and Hb
  3. fall in reticulocytes
27
Q

what are the features of sickle cell hemolytic crisis?

A
  1. acute drop in Hct and Hb

2. large rise in reticulocytes - increased destruction state

28
Q

what is the treatment for sickle cell hemolytic crisis?

A

prophylactic antibiotics

Year 2 Hematology (34 decks)

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