Exam #4/Final

Question 1

Anemia

Answer 1

Decrease in # of RBCs and/or Hgb; causes decreased oxygen carrying capacity
Change in size, shape, and/or color

Question 2

Consequences of Anemia

Answer 2

Decreased O2 carrying capacity
Hemodilution 
Decreased peripheral resistance 
Increased cardiac circulation/turbulence 
Cyanosis 
Growth retardation

Question 3

Management of Anemia

Answer 3

Tx underlying cause 
IV fluids
O2
Bed rest 
Decrease O2 demands

Question 4

Iron deficiency anemia

Answer 4

inadequate supply of dietary iron
Adolescents at risk because rapid growth and poor eating habits
Manage: Diet changes and iron supplements

Question 5

Sickle cell anemia

Answer 5

hereditary; primarily in African American
Mediterranean descent, South America, Arabian, and East Indian
** If both parents have trait, each offspring have 1/4 chance of having disease

Question 6

Pathophysiology of Sickle cell

Answer 6

elongated “sickle” shaped RBCs
rigid and obstruct capillary blood
engorgement and tissue ischemia
Hypoxia occurs causing sickling

Question 7

Diagnosis and management of Sickle Cell anemia

Answer 7

Cord blood, genetic testing- sickle turbidity test
prophylactic ABX 2mon-5yrs
monitor CBC 
blood transfusion 
Iron and orange juice 
Rx: Hydroxyurea

Question 8

Thalassemia

Answer 8

inherited disorder of Hgb synthesis, autosomal recessive- both parents must be carriers
Chronic hypoxia- HA, irritability, bone pain, exercise intolerance, anorexia, epistaxis
BABIES: pallor, Failure to thrive, hepatosplenomegaly, severe anemia, FUSSY
TX: transfusion and chelation

Question 9

Aplastic anemia

Answer 9

all formed elements of blood are depressed “pancytopenia”
TX: immunosuppressive therapy and bone marrow transplant
NOT life long

Question 10

Hypoplastic anemia

Answer 10

profound depression of RBCs but normal WBCs and platelets
TX: immunosuppressive therapy and bone marrow transplant
NOT life long

Question 11

Hemophylia

Answer 11

a group of hereditary bleeding disorders that result from deficiencies of clotting factor
X-linked recessive
life long; limit activities= NO contact sports
Tx: Demopressin, replace clotting factor, transfusions

Question 12

Hemophylia A

Answer 12

classic hemophylia
lack factor 8
1 in 5000 males

Question 13

Hemophylia B

Answer 13

lack of factor 9

only 15% of cases

Question 14

Von Willebrand’s Disease

Answer 14

hereditary; lacking plasma protein and carrier for factor 8

Watch for bleeding

Question 15

Idiopathic Thrombocytopenia

Answer 15

hereditary; excessive destruction of platelets
purpura- discoloration from petechiae- starts at feet and goes up
decreased clotting ability

Question 16

Epitaxis (nose bleed)

Answer 16

common in childhood
recurrent or severe = underlying disease
remain calm, sit child up and lean forward, pressure on nose, further evaluation

Question 17

HIV/AIDS

Answer 17

spread by retrovirus HIV through body secretions
TX: Zidovudine, nutrition supplements, vaccines, antiretroviral therapy, antibacterial agents
Use STANDARD precaution

Question 18

Hypopituitarism

Answer 18

growth hormone deficiency, inhibits somatic growth
Family Hx, will be small
Give GH in IM

Question 19

Pituitary Hyperfunction

Answer 19

overgrowth of long bones; excess GH

Question 20

Precocious Puberty

Answer 20

sexual development before age 9 in boys and age 8 in girls
more common in girls
Give hormone therapy to stop

Question 21

Hypothyroidism

Answer 21

Congenital or Acquired
Mental decline, Constipation, sleepiness, dry skin, sparse hair, puffiness around eyes
TX: levothyroxine- Synthroid
blood test q6 months

Question 22

Goiter

Answer 22

Hypertrophy of the thyroid gland
usual cause- antithyroid drug during pregnany
TX: remove goiter, stop antithyriod hormone production

Question 23

Lymphatic Thyroidosis

Answer 23

Hashimoto’s disease or juvenile autoimmune

Tx: levothyroxine

Question 24

Graves

Answer 24

hyperthyriodism; autoimmune response Enlarged thyroid gland

Peak at 12-14 yrs