Child with Palor Flashcards

1
Q

What’s the normal Hb of a newborn?

A

10-12

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2
Q

What is the equation for O2 delivery?

A

CO x Hb x SpO2 x 1.31

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3
Q

Where does the 1.31 come from in the O2 delivery equation?

A

Amount of oxygen carried by 1g of Hb

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4
Q

For how long is breast milk a good source of iron?

A

Six months

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5
Q

What are some symptoms of anaemia

A
Lethargy
SOB
Fatigue
Chest pain 
Poor school performance
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6
Q

What is the most common cause of iron deficiency in kids?

A

Poor nutrition

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7
Q

Why does a cow milk diet course iron deficiency anaemia?

A

Reduces appetite for other foods
The iron it contains isn’t as bioavailable
Cow’s milk allergy causing occult loss

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8
Q

Why do premature babies get iron deficient?

A

Maternal iron is transferred in the third trimester

Iatrogenic loss

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9
Q

Why don’t you replace iron in preterm babies immediately?

A

It increases the risk of certain bacterial infections

Start at around 4 weeks

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10
Q

What must you consider when interpreting iron studies in children?

A

Ferritin may be falsely normal or elevated due to infection/inflammation

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11
Q

How can you clarify the results of iron studies?

A

Reticulocyte count

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12
Q

How do you investigation Fe def.

A

FBE and film
Iron studies
Reticulocyte count

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13
Q

How do you differentiate Fe def and thalassaemia?

A

RDW - Fe def is higher

Hb electrophoresis

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14
Q

How do you replace Fe?

A

Oral supplementation

Infusion (caution anaphylaxis), not used as much in kids

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15
Q

What do you advise parents about iron supplementation

A
Can course constipation and abdo pain
Take with vitamin C, not on an empty stomach
Don't overdose 
Dark stools 
Brush teeth after taking it
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16
Q

What happens in iron ingestion overdose?

A

Inflammation of GIT

  • mucosal inflammation
  • Strictures
17
Q

How long do you take oral iron for?

A

At least a month - usually 2 months

18
Q

How do you tell if someone is responding to iron in anaemia?

A

Increases reticulocyte count

19
Q

How does thalassaemia major present?

A

Hypertrophy of maxillary bones

Hepatomegaly

20
Q

How do you decide whether to transfuse?

A

Symptomatic or not
Comorbidities
Progressive or not

21
Q

How do you decide how much blood to give?

A

Weight (kg) x DeltaHb (g/dL) x 3-4 = ml of blood

22
Q

How many ml of blood in a unit?

A

250ml

23
Q

What is the maximum length of time over which a transfusion should be given?

A

6hr

Practically 4 hours

24
Q

What do you accompany the administration of blood with (in most cases)?

A

Accompany with diuretic so as not to overfill

25
Q

What must you do when administering blood?

A

Check that everything matches

Monitor - every 5 minutes for first half hour