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Paeds - C.U > Blood and cancer > Flashcards

Blood and cancer Flashcards

1
Q

Triad of bone marrow failure

A

anaemia
thrombocytopenia
neutropenia

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2
Q

Triad of tissue infiltration

A

bone pain
hepatosplenomegaly
lymphandenopathy

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3
Q

1st line investigations in suspected leukaemia

A

FBC
Blood film
CXR
Clotting screen

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4
Q

Specialist investigations in leukaemia

A

Bone marrow aspirate

LP

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5
Q

Features of Kawasaki disease

A 
High grade fever >5 days 
Conjuntival infection 
Bright red cracked lips 
Strawberry tongue 
Cervical lymphadenopathy
Red palms of hands and soles
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6
Q

Treatment of Kawasaki disease

A

Aspirin IV

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7
Q

AB for suspected meningococcal disease

A
  • ceftriaxone
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8
Q

steroids given in x but not y?

A

bacterial meningitis

NOT meningococcal septicaemia

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9
Q

commonest cause of anaemia in children

A

iron deficiency

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10
Q

3 main causes of iron deficiency anaemia

A

insufficient intake
malabsorption
chronic blood loss

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11
Q

severe side effects of low iron

A

decreased cognitive and psychomotor performance

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12
Q

blood film for iron deficiency anaemia

A

hypo-chromic, microcytic cells

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13
Q

Management for iron deficiency anaemia

A

dietary advice - limit milk intake
iron replacement therapy (continue 2-3 months after target levels met)
RARE - transfusion

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14
Q

what protein is dysfunctional in sickle cell anaemia in children?

A

beta globin chain - causes RBC to deform when deoxygenated

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15
Q

sickle cell crisis =

A

deformed RBC get stuck

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16
Q

sickle cell crisis triggers

A 
hypoxia 
cold 
dehydration 
excessive exercise 
infection 
stress
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17
Q

up to which month is sickle cell not a problem in new borns

A

6m - foetal hb still in the blood

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18
Q

acute treatment in sickle cell crisis

A

analgesia
oxygenation
treatment of the associated sepsis

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19
Q

long term treatment in sickle cell disease

A

prophylactic penicillin
appropriate vaccinations
close monitoring for complications

can give steroids / blood transfusion

HSCT - replace BM - extreme, reserved for severe disease

20
Q

genetic inheritance of thalassaemia

A

autosomal recessive

21
Q

what is affected in a RBC in thalassaemia?

A

globin chain - alpha / beta

22
Q

thalassaemia major =

A

total absence of the production of that globin chain

23
Q

thalassaemia intermedia =

A

milder symptoms

24
Q

thalassaemia trait =

A

asymptomatic

25
Q

type of anaemia in thalassaemia =

A

microcytic

26
Q

clinical features of thalassaemia =

A 
delayed growth 
congestive HF 
splenomegaly 
bone deformity 
increased risk of infections 
iron overload
27
Q

management of thalassaemia

A

regular blood transfusions
check iron levels
iron chelation
HSCT

28
Q

Causes of anaemia in children due to RBC being destroyed….

A 
G6PD 
Sickle cell 
Thalassaemia 
Drug induced / viral haemolytic anaemia 
Physiological anaemia of the new born
29
Q

Causes of anaemia in children due to RBC being lost

A

Haemorrhagic disease of the new born
Cows milk protein enteropathy
Clotting disorders
Menstruation

30
Q

Causes of anaemia in children due to body producing RBC too slowly

A

Iron deficiency
Chemo
Leukaemia

31
Q

What is immune thrombocytopenic purpura?

A

Viral trigger leads to development of platelet membrane glycoprotein AB
So autoimmune destruction of platelets

32
Q

clinical features of immune thrombocytopenic purpura

A

low platelets
petechial rash
excessive purpura bruising
unexplained bleeding

33
Q

Therapy for ITP if significant bleeding

A

IV Ig and oral corticosteroids / IV anti D

Should do bone marrow aspirate before giving the corticosteroids

34
Q

Henoch Scholein Purpura =

A

Ig A vasculitis

35
Q

what is IgA vasculitis precipitated by?

A

infections and vaccinations

36
Q

Clinical features of IgA vasculitis

A

Purpuric rash
Arthralgia - especially knees and ankles
Abdo pain
Renal compromise

37
Q

rash in HUS / IgA vasculitis

A

Raised purpuric rash over buttocks and extensor surfaces of the limbs.

38
Q

Ddx for purpuric rash but platelets normal

A

HSP
Viral infection
NAI
Meningitis / Septicaemia

39
Q

Ddx for purpuric rash but platelets low

A

acute lymphoblastic leukaemia

40
Q

follow up for HUS / IgA vasculitis

A

BP and urine dip

41
Q

Investigations in acute IgA vasculitis

A 
BP
Urine dip 
Renal function 
Albumin 
FBC 
Clotting
42
Q

Management of IgA vasculitis

A

symptomatic - pain relief but NOT NSAIDS IF RENAL IMPAIRMENT

43
Q

Neuroblastoma =

A

cancer along sympathetic chain / adrenal glands

44
Q

Wilms tumour =

A

nephroblastoma

45
Q

Ewings sarcoma =

A

central skeleton cancer

46
Q

Osteosarcoma =

A

long bone cancer

47
Q

What can a rhabdomyosarcoma be found?

A

Bladder
Pelvis
Nasopharynx
Parameningeal

Paeds - C.U (10 decks)

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