Childhood Anemia

Question 1

Define Anemia

Answer 1

Red RBC, Hemoglobin, Red volume of RBC

Decreased O2 carrying capacity to support life

Question 2

What does lab data look like to make diagnosis of anemia?

Answer 2

RBC Indices - Low 70 + age
 upper limit 84+.6xage
RDW - high in iron deficiency
     - Normal in thalassemia
WBC/platelets - Inc WBC/low platelets can be sign of infection
    - Norm WBC/Low platelet wiht mild anemia - platelet prob
Peripheral smear - size
Reticulocytes - tells about marrow

Question 3

Classify childhood anemia by size of RBC

Answer 3

MCV
Lower limit 70 + age
Upper 84 + 0.6xage

Question 4

What is a history consistent with Iron Deficiency Anemia?

Answer 4

excessive milk intake
dont eat anything else - milk doesnt have much iron
dont let them have milk until one year
MCV down, RDW inc, Ferritin/Transferrin dec, TIBC inc, Retic is normal/inc

Question 5

What are the complications of Sickle Cell Anemia in children?

Answer 5

100% hgb is SS
Chronic Hemolytic anemia
Sickle Crises
 - Vaso occlusive pain,  - 
      - #1, acidosis, dehydration, sickling stuck in syste and hurts. hospitalizations.
 - Aplastic, 
 - Hemolytic/splenic sequestration.

Question 6

What is a simple treatment plan for:

Diamond Blackfan Anemia?

Answer 6

Dx under one yr. anemia, MCV normal, Retic low, HgF inc, PHYSICAL FINDINGS Snub nose, wide eyes, flat thenar eminence, triphylangeal thumb, short

Tx: Prednisone tx, transfusion, bone marrow transplant

Question 7

What is a simple treatment plan for:

Iron Deficiency Anemia?

Answer 7

Give Iron until improvement in Hemoglobin.

wait 30 days to see rise.

Question 8

What is a simple treatment plan for:

Transient Erythroblastopenia of Childhood?

Answer 8

VIRUS then get pale
less than 1 yr. bone marrow not making cells

Just watch supportive therapy. they come back around.

Question 9

What are the complications of Sickle Cell Anemia and Prevention and Tx strategies for them?

Answer 9

Vaso-Occlusive: Supportive - hydration, narcotics, O2, watch body systems, may need transfusion, hydroxyurea can be helpful by inc HgbF-
Aplastic Crisis: Parvovirus
- Transfusion necessary
Hemolytic Crisis:
Splenic Sequestration Crisis: spleen gets big.
Infection: salmonella

Infection Risk - Vaccinate

• against S. Pneumo, H flu, N mening,
• Give PCN