Ch. 453 - Physiologic Anemia of Infancy

Question 1

T/F Physiologic anemia of infancy is related to downregulation of EPO production from increase in blood O2 content and delivery with a shift in type of Hgb synthesized (fetal to adult type)

Answer 1

T

Question 2

Physiologic anemia is reached between ___ and ___ weeks of age when hgb concentration is about ___g/dL

Answer 2

8 and 12, 11

Question 3

In healthy term infants, the nadir of physiologic anemia rarely falls below ___

Answer 3

10g/dL

Question 4

Is there a need for iron supplementation for hgb synthesis in physiologic anemia of infancy

Answer 4

No; supply of stored reticuloen- dothelial iron, derived from previously degraded RBCs, remains suf- cient for this renewed Hb synthesis, even in the absence of dietary iron intake, until approximately 20 wk of age

Question 5

T/F Physiologic anemia of infancy reflects excess tissue O2 requirements relative to O2 delivery

Answer 5

F; excess oxygen delivery relative to tissue oxygen requirements

Question 6

T/F There is no hematologic problem, and no therapy is required unless physiologic anemia of infancy is exacerbated by other ongoing processes.

Answer 6

T

Question 7

Mild hemolytic disease of newborn may be seen with the persistence of maternally-derived anti-RBC Abs in the infant’s circulation, leading to low-grade hemolytic anemia; Retic count in mild HDN is

Answer 7

Low

Question 8

Lower-than-expected hgb at the physiologic nadir of hgb in infants may be seen in what conditions

Answer 8

Mild HDN, intrauterine or neonatal RBC transfusions

Question 9

T/F Premature infants develop a physiologic anemia, known as physiologic anemia of prematurity where hgb decline is both more extreme and more rapid

Answer 9

T

Question 10

Nadir in physiologic anemia of prematurity is seen when

Answer 10

3-6 weeks of age

Question 11

Usual level of physiologic anemia of prematurity

Answer 11

7-9g/dL

Question 12

Life span of premature infant RBC

Answer 12

40-60 days

Question 13

T/F Plasma EPO levels in anemia of prematurity are lower than would be expected for the degree of anemia

Answer 13

T

Question 14

During fetal life, EPO synthesis is handled primarily by what organ

Answer 14

Liver

Question 15

T/F Oxygen sensor of the liver is relatively insensitive to hypoxia when compared to the oxygen sensor of the kidney

Answer 15

T

Question 16

The developmental switch from liver to kidney EPO production is not accelerated by early birth

Answer 16

T

Question 17

T/F Vitamin E deficiency plays a role in anemia of prematurity

Answer 17

F

Question 18

When transfusions are necessary for physiologic anemia of newborn, ___ is the amount recommended

Answer 18

10-15cc/kg

Question 19

T/F It is good practice to split units derived from a single donor so that sequential transfusions can be given as required and donor exposure can be minimized.

Answer 19

T

Question 20

In early preterm infants (weighing <1,250 g), the half-life of transfused RBCs is about ___

Answer 20

30 days

Question 21

T/F Delayed cord clamping or umbilical cord milking at birth results in fewer transfusions and a reduction in both intraventricular hemorrhage and necrotizing enterocolitis in preterm infants.

Answer 21

T