Hema Flashcards
Physiologic anemia of infancy usualy lasts for how many weeks?
8-12
Physiologic anemia of prematurity has hemoglobin levels of
7-9 g/dl
Does physiologic anemia of prematurity require treatment?
Yes EPO or transfusion
Most important sign of iron deficiency anemia
Pallor
Expected rise in hemoglobin per day after iron treatment
0.1-0.4 g/dl
Treatment for IDA
Elemental iron
3-6mg/kg/day
After treatment of IDA, Repeat CBC should be done after
4 weeks
Target cells
Heinz bodies
Decreased retic count
Normal RDW
Thalassemia
Definitive diagnosis of thalassemia can be done through
Hb electrophoresis
This infection should be watched out for in thalassemia because it eats up the free iron
Yersinia enterocolitica
Tachycardia and splenomegaly
Increased reticulocyte and MCHC normal platelet count
Spherocytosis
Defect in spectrin or ankyrin
Osmotic fragility test
Increased MCHC, retic count
Normal MCV
Spherocytosis
Vasoocclusive crisis
Autosomal recessive
Crew cut or hair on end appearance of skull in xray
Howell Jolly bodies
Sickle cell anemia
Treatment for sickle cell
Hydration and analgesia for acute crises
Most common hereditary bleeding disorder
vWD
Most common and most serious congenital coagulation factor deficiency?
Hemophilia A
Most common hereditary hypercoagulable disorder?
Factor V Leiden
Hallmark of hemophilia
Prolonged bleeding
Earliest joint hemorrhage in children
Ankles
Treatment for mild von willebrand disease type 1
Desmopressin
Laboratory finding in hemophilia
Increased PTT
Laboratory finding in vWD
Increased PTT and bleeding time
Laboratory finding in ITP
Increased bleeding time
Decreased platelet
Laboratory finding in vitamin K deficiency
Increased PT
Laboratory finding in DIC
Decreased platelet count
Increased PT PTT bleeding time
What type of leukemia in childhood will have the best response to chemotherapy?
ALL
Site of relapse of ALL
bone marrow
CNS
Testes
Site of spread of ALL
Liver
Spleen
Lymph nodes
<2 years >10 years old Male WBC >100,000 on presentation CNS involvement Mediastinal mass
Poor prognostic factors of what disease
ALL
Renal tumor of embryonal origin
Wilms tumor
Painless abdominal enlargement with flank mass that DOES NOT cross the midline
Wilms
Drug of choice for PCP prophylaxis in children with ALL undergoing chemotherapy is
Co-trimoxazole
Embryonic tumor of neural crest origin
Neuroblastoma
Most common site where neuroblasts migrate
Sympathetic ganglia and adrenals
Differential diagnosis of small, round, blue cell tumors
WARMER PN
Wilms Acute leukemia Rhabdomyosarcoma Mesothelioma/medulloblastoma Ewing sarcoma Retinoblastoma Primitive neuroectodermal tumor (PNET) Neuroblastoma
Associated with:
Neurofibromatosis
Beckwith- Weidemann syndrome
WAGR syndrome
Wilms tumor
Associated with: N-myc oncogene Neurofibromatosis Hirschprung Tuberous sclerosis Pheochromocytoma
Neuroblastoma
Horner syndrome Abdominal mass that MAY cross the midline Cord compression Racoon eyes Dancing eyes and feet
Neuroblastoma
Diagnosis for neuroblastoma
Urine VMA and HVA
Abdominal CT
Bone marrow aspirate
Long bones and skull BM Liver LN Skin
Most common metastatic sites of
Neuroblastoma
What are the B symptoms of
Lymphoma?
High grade fever
Weight loss
Night sweats
Regional lymphadenopathy Chemotherapy Bimodal age distribution EBV, CMV, HHV 6 Reed Sternberg cells Contiguous LN spread
Hodgkin lymphoma
Hodgkin lymphoma type that has the Best prognosis
Mixed cellularity lymphocyte predominant
Systemic adenopathy Radiation for CNS involvement Chemotherapy 60% of lymphomas in chidren and adolescent EBV- Burkitt Non contiguous LN spread
Non-Hodgkin
Results from failure or autoimmune destruction of myeloid stem cells
Aplastic anemia
Most likely cause of aplastic anemia
Idiopathic
Typical PBS finding in aplastic anemia
Hypocellularity and pancytopenia
Aplastic anemia with microcephaly, microphthalmia, hearing loss and limb anomalies
Fanconi anemia