Heamatology Flashcards
what are the Risk factors for IRON deficiency Specifically in children? (5) [Pediatrics]
Dietary deficiency of IRON
Increased demand-growth sports (first 2 years & Puberty)
Preterm / Low birth wieght baby. - Low iron stores
malabsorption
Hook worm infestation
what are the clinical features of IRON Deficiency anemia
pallor, Irritability, fatigue,
Koilonychia - Spooning of nail
platynychia -flat nails
Glossitis- Inflammation of Tongue
angular stomatitis
what are associated clinical situations found in Iron deficiency anemia?
PICA
Temper tantram
Breath holding spells
Rest less Leg Syndrome
what are the Laboratory findings found in Iron deficiency Anemia?
Microcytosis, Anisocytosis
Low mean corpuscular volume
Low Serum ferttin levels
True/false:
. In the first 6-9 months children are more prone to IRON Deficiency Anemia As Breast milk of Mother contians only very little amount of IRON
false
## foot note
in the first 6-9 months - No Anemia as Iron stores are derived from the mother during the Last Trimester of pregnancy
what is treatment for Iron deficiency anemia?
ferrous sulfate. 3-6 mg/kg/day upto 4-6 months (till Iron stores are replenished)
ferrous sulfate is the most economical and effective of IRON
& it contains 20%, elemental IRON
what are responses would you expect in your patient after starting IRON therapy?
12-24 hrs —– subjective Improvement & Replacement of Intracelluar Iron enzymes
36- 48 hrs —–Bone marrow response Erythroid hyperplasia (Increase in erythroad cells)
48 -72 hrs —–Reticulocytosis-peaks at 5 to 7 days
4-30 days —– Increase in heamoglobin
1 to 3 months —– Replenish Iron Stores
what are the causes of megaloblastic anemia?
Deficiency of Vit B 12 & folic acid
what are the causes of Vitamin B12 deficiency?
I. Dietary—a) pure vegetarian & Vegan
II. Pernicious anemia
Ill. malabsorption —
a) crohns disease
b) Chronic Pancreatitis
C) Diphyllobothrium Latum (fish tapeworm)
IV. metabolic
a. Homocystinuria
b. orotic aciduria
C. methyl malonic Aciduria/MMA
what are the causes for folic acid deficiency?.
I.Dietary—- excess ingestion of goat milk
ll. malabsorption—– Giardia
Ill. Drugs ——
a.6 mercaptopurine
b. methotrexate
C. Trimethoprim
what are the clinical features of folic acid deficiency?
Pallor
smooth beefy red tongue
Hepatospleenomegaly - 30-40%.
Hyperpigmentation of knuckles
pre-Dispose with neurological features (loss of position & vibration sense & unsteady gait & paresthesia)
what are the findings of the folic acid deficiency in peripheral smear?
macrocytosis (large sized R.B.C)
Hyper sigmented neutrophils
what is treatment for folic acid deficiency anemia?
1 to 5 mg of folic acid daily for 3 to 4 weeks
vitamin B12 1000 mcg orally
Daily for 2 weeks
weekly for next 2 weeks
monthly for Lifetime
what type of inheritance is seen in fanconi Anemia?
A) Autosomal dominant
B) Autosomal recessive
C) x-linked dominant
D) X-linked recessive
B. Autosomal recessive
Defects in D.N.A repair (chromosomal Breaks are seen in Cells)
what are the clinical features seen in fanconi anemia? (3 pis)
pallor,petechial heamorhages, purpura.
Increased Infections
short sature, skeletal anomalies (radial ray defects), skin pigmention (hyperpigmentation, cafe-au-Laut macules)
microcephaly + Tapering Jaw
what is the treatment for fanconi anemia?
Hematopoietic stem cell Transplantation & oral Androgens
Long term follow up due to increased risk of
Acute myeloid Leukemia & oral & Liver cancer
what are normal Levels of HB As per age?
6 months to 60 months —– 11 g/dL
5 yrs to ll yrs —— 11.5 g/dL
> /= 12 yrs —–12 g/dL
what would you suspect If Anemia occurs along with splenomegaly?
Leukemia, Hemolytic disorders
what would you suspect If anemia occurs along with Generalized Lymphadenopathy?
Leukemia , systemic onset Juvenile Idiopathic arthritis
what would you suspect If anemia occurs along with congenital anomalies?
fanconis anemia
what would you suspect If anemia occurs along with Petechiae?
Leukemia
APlastic Anemia
Hemolytic uremic syndrome
