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Pediatrics Final Exam > Hematology > Flashcards

Hematology Flashcards

1
Q

Hemoglobin

Hematology

A

Oxygen-carrying protein in blood

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2
Q

Hematocrit

Hematology

A

Portion of RBC; plasma in blood

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3
Q

Mean Corpuscular Volume (MCV)

Hematology

A

Average size of RBCs

  • volume
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4
Q

Mean Corpuscular Hemoglobin (MCH)

Hematology

A

Average mass of hemoglobin per RBC

  • “color or capacity”
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5
Q

RBC Distribution Width (RDW)

Hematology

A

Measures variation of RBC size

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6
Q

Anemia

Hematology

A

Reduction in the number of RBCs, the quantity of hemoglobin, & the volume of packed RBCs

Causes:
1.) ↓ RBC production (bone marrow infiltrtation / injury, nutriiton deficiency, ineffective erythropoiesis, erythropoietin deficiency)

2.) blood loss (trauma, destruction, or hemolysis)

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7
Q

Microcytic Anemia

Hematology

A

Cell is physically small

  • usually characterized by ↓ MCV (Mean Corpuscular Volume) & ↓ MCH (Mean Corpuscular Hemoglboin)
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8
Q

Macrocytic Anemia

Hematology

A

Unusually large RBC

  • enough supplies in the factory but there are not enough workers

  • large RBCs
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9
Q

Normocytic Anemia

Hematology

A

Destruction or ↓ # of RBCs

  • normal sized RBC & normal MCV
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10
Q

Iron Deficiency Anemia

Hematology

A

Microcytic Anemia due to lack of iron (low ferritin)

  • Primarily affects toddlers who drink a lot of milk (more than 16-24 oz / day) & adolescents with menorrhagia or GI bleeding
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11
Q

Signs & Symptoms of Iron Deficiency Anemia

Hematology

A
  • irritability
  • pallor
  • fatigue
  • pica
  • tachypnea
  • cardiomegaly
  • angular stomatitis (angular cheilitis)

  • elevated hemoglobin, hematocrit, MCV, MCH, RBC count, & reticulocyte count

Normal hemoglobin = 10.2 - 13.4 g/dL (anything below 11 g/dL indicates anemia)

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12
Q

Iron Deficiency Anemia Treatment

Hematology

A

Supplemental iron; 2-5 mcg/kg/day

  • take with vitamin C for improved absorption
  • do NOT take with milk (Ca+ inhibits abnorption)
  • labs will likely return to normal in 2 months

Side Effects: GI, N/V, constipation, dark stools

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13
Q

Cause of Macrocytic Anemia

Hematology

A

Often caused by Vitamin B-12 (folate) deficiency

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14
Q

Cause of Microcytic / iron deficiency anemia

Hematology

A

Low iron (ferritin)

Mainly impacts:
* toddlers who drink a lot of milk
* adolescents w/ GI bleed or menorrhagia

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15
Q

Sickle Cell Anemia

Hematology

A

Sickle-shaped RBCs (sickle cell hemoglobin - HbS)

  • As cells lose their donut shape, they become sickle shaped which causes them to be stiff, “sticky”, & obstructive

  • Type of normocytic anemia
  • autosomal recessive
  • affects African American or Mediterranean
  • sickle cells have a decreased life span of 10-20 days compared to normal RBCs which have a lifespan of 120 days
  • The bone marrow then cannot keep up to replace the cells & patients are chronically anemic
  • HIGH reticulocytes
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16
Q

Types of Sickle Cell Disease

Hematology

A

1.) Hb SS = sickle cell anemia
* crescent-shaped RBCs

2.) HbSC = sickle Cell disease
* RBCs are “C” shaped

17
Q

HbSS

Hematology

A

Sickle Cell Anemia

  • most common type of sickle cell disease
  • patient inherets 2 sickle genes
  • child subject to sickle cell crises
  • more severe complications

RBCs are crescent-shaped

18
Q

HbSC

Hematology

A

Sickle Cell Disease

  • milder form of sickle cell
  • individual has one HbS gene & one HbC gene
  • less severe, but can still experience sickle cell crises / vaso-occlusive complications

RBCs are “C-shaped”

19
Q

What are the 3 types of Sickle Cell Crises?

KNOW THIS!!!!!

Hematology

A

1.) Vaso-occlusive (pain)
2.) Splenic sequestration
3.) Anaplastic crisis

20
Q

Vaso-Occlusive Crisis

Hematology

A

PAIN CRISIS

  • Stasis of blood with clumping of cells in the micro-circulation, ischemia, & infarction
  • Most common sickle cell crisis

Causes:
* dehydration
* temperature extremes
* infection
* localized hypoxemia

21
Q

Signs & Symptoms of Vaso-Occlusive Crisis

Hematology

A

Extremely Painful Symptoms including:

  • fever
  • tissue engorgement
  • painful swelling of joints (in hands & feet)
  • Priapism (elongated erection time)
  • Severe abdominal pain
22
Q

Vaso-Occlusive Crisis Treatment

Hematology

A
  • IV hydration
  • monitor perfusion / infection
  • pain management
23
Q

Splenic Sequestration Crisis

Hematology

A

Pooling of blood in the spleen (rupture risk)

  • life-threatening crisis – death can occur within hours
24
Q

Signs & Symptoms of Splenic Sequestration Crisis

Hematology

A
  • Profound anemia
  • Hypovolemia
  • Shock
25
**Aplastic Crisis** ## Footnote **Hematology**
**Triggered by infection or full depletion of folic acid** * life-threatening
26
**Signs & Symptoms of Aplastic Crisis** ## Footnote **Hematology**
* **Destruction of RBCs** * Pallor * Profound anemia
27
**What is Acute Chest Syndrome?** | **KNOW THIS!!!!!** ## Footnote **Hematology**
**Blockage of blood vessels in the chest leading to pneumonia** * common * acute lower respiratory tract infection * complication of sickle cell disease & vaso-occlusive crisis Considered a **medical emergency** * leading cause of death in kids with sickle cell **Tx:** cefepime; IV hydration, O2, RBC transfusion, analgesics
28
**Sickle Cell Crisis Triggers** ## Footnote **Hematology**
* extreme temperatures * dehydration * stress
28
**Signs & Symptoms of Acute Chest Syndrome** | **KNOW THESE!!!!!** ## Footnote **Hematology**
* **Pulmonary infiltrates** on CXR * **Fever** * **Chest pain** * **Tachypnea** * **Wheezing** * **Difficulty breathing** * **↓ O2 saturation** ## Footnote **Pulmonary Infiltrates =** substance that accumulates in the lungs like **pus, blood, or protein** that is denser than air
29
**Medications for Treatment of Sickle Cell** | **KNOW THESE 2** ## Footnote **Hematology**
**Folic Acid = increases turnover of RBCs** * helps with DNA / protein synthesis to increase RBC production **Hydroxyurea = decreases RBC adhesion** * increases HgF levels & decreases HgS (HgF competes with HgS)
30
**Treatments for Sickle Cell Disease** ## Footnote **Hematology**
**Folic Acid:** increases cell turnover **Penicillin** * spleen doesn't work until age 5 **Hydroxyurea:** med that decreases red blood cell adhesion * ↑ HgbF (fetal hemoglobin) * ↓ HgbS (sickle cell hemoglobin) **Supportive Care** **Stem Cell Transplant** (hematopoetic stemm cells)

Pediatrics Final Exam (5 decks)

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