Hematology Flashcards
What is hemolytic anemia?
Accelerated destruction of red blood cells (RBC)
What usually happens to reticulocyte count in hemolytic anemia?
Increased reticulocyte count except in cases of bone marrow suppression
What is alloimmune hemolytic anemia?
Destruction of fetal or neonatal RBCs by maternal IgG antibodies
What are some causes of anemia?
- Consumption/Destruction
- Infection (Viral and bacterial)
- Disseminated intravascular coagulation (DIC)
- Maternal autoimmune thrombocytopenia
What is thrombocytopenia?
Platelet count < 120,000
What is the life span of platelets?
7-10 days
What is the treatment for thrombocytopenia in the absence of signs/symptoms?
Controversial, consider conservative management with adequate hydration
What is the goal of treatment for polycythemia?
Reduce hematocrit to less than 60%
What are the clinical presentations of polycythemia?
- Asymptomatic
- Plethora
- Cyanosis
- Respiratory distress
- Lethargy
- Jitteriness
- Seizures
- Congestive heart failure
What is hemorrhagic disease of the newborn?
A condition caused by vitamin K deficiency leading to bleeding
What are the clinical presentations of hemorrhagic disease of the newborn?
- Pallor
- Localized or diffuse bleeding
- Gastrointestinal bleeding
- Jaundice
- Intraventricular or intracranial hemorrhage
What is the etiology of neonatal alloimmune thrombocytopenia?
Antibody developed by mother against paternally inherited antigen on baby’s platelets
What is the treatment for neonatal alloimmune thrombocytopenia?
Transfusion of washed, irradiated maternal platelets
What is the incidence of vitamin K deficiency in newborns?
0.4 – 1.7 per 100 live births
What are the risks of transfusion?
- Infection
- Transfusion reactions
- Metabolic complications
- Graft versus host disease
- Fluid overload
What is Rh disease?
Condition where Rh negative mother produces anti-D IgG against Rh positive blood
What is the treatment for Rh disease?
rhoGAM to destroy Rh positive fetal cells in mother’s bloodstream
What is α thalassemia?
Defect in synthesis of globin chains leading to ineffective erythropoiesis
What is β thalassemia?
Not usually diagnosed before 2 months of age, presents with hemolytic anemia
What does G6PD deficiency lead to?
Weakens red cell wall making it more susceptible to destruction
What happens in sickle cell disease?
Neonates are generally asymptomatic but can develop complications
What is the clinical presentation of anemia?
- Pallor
- Shallow, rapid, irregular respirations
- Tachycardia
- Weak, absent pulses
- Hypotension
What are the normal values of WBC in term infants?
10,000 – 26,000
What is the normal reticulocyte count for preterm infants?
3% - 10%
What are the laboratory studies for diagnosing anemia?
- CBC and differential
- Retic count
- Hemoglobin
- Total and direct bilirubin
What is the significance of a D-Dimer test?
Marker for endogenous thrombin/plasmin production
What is the role of vitamin K in coagulation?
Required for the activation of factors II, VII, IX, and X
What is the main complication of polycythemia?
Increased blood viscosity leading to decreased blood flow to organs
Fill in the blank: The treatment for acute anemia includes ______.
Whole blood or packed red blood cells (PRBCs)
True or False: Thrombocytopenia is usually symptomatic.
False
What are the normal hematocrit values for preterm infants?
45% - 50%
Hematocrit values gradually decrease during the first 6 weeks of life.
What are the normal hematocrit values for term infants?
50% - 60%
Hematocrit values may not reflect volume changes from delayed cord clamping.
What is the life span of red blood cells (RBCs) in adults?
100-120 days
What is the life span of red blood cells (RBCs) in term infants?
60-70 days
What is the life span of red blood cells (RBCs) in preterm infants?
35-50 days
What is the major iron-carrying component of red blood cells?
Hemoglobin
What are the normal hemoglobin values for preterm infants?
14-16 gm/dl
What are the normal hemoglobin values for term infants?
16-18 gm/dl
What is the function of erythropoietin?
Regulates the production of RBCs
What factors can increase erythropoietin levels?
Anemia and low oxygen availability
What is the significance of nucleated red blood cells (NRBCs)?
Indicates chronic fetal hypoxia or placental insufficiency
What are the components of a complete blood count (CBC)?
- RBCs
- Hemoglobin
- Hematocrit
- Platelets
- Reticulocytes
- WBCs
What are the normal values of absolute neutrophil count (ANC) in neonates?
2,500 – 13,000
What does a left shift in neutrophils indicate?
Increased immature neutrophils in response to infection
What are the types of white blood cells (WBCs)?
- Neutrophils
- Lymphocytes
- Monocytes
- Eosinophils
- Basophils
What is neutropenia?
Exists when an infant consumes its neutrophil pool faster than it can be replenished
What is the role of eosinophils?
Commonly associated with allergic responses or parasites
What are the common inherited bleeding disorders?
- Hemophilia A (Factor VIII deficiency)
- Hemophilia B (Factor IX deficiency)
- von Willebrand disease
True or False: Capillary hemoglobin values are lower than venous values.
False
Fill in the blank: The RBC life span in term infants is ______ days.
60-70
What is the clinical presentation of anemia in infants?
Hgb < 13 gm/dl or Hct < 40% during the first week after birth
What is the definition of iatrogenic blood loss?
Significant blood loss due to medical interventions during a patient’s hospital course
What factors can affect complete blood count (CBC) values?
- Site of blood draw
- Activity level of the infant
- Iatrogenic losses
What is the function of basophils?
Secrete anticoagulant and vasodilatory substances
What is the significance of reticulocytes in the blood?
Indicates the production of new red blood cells
What does a high level of immature neutrophils suggest?
Depletion of the neutrophil storage pool
