Hematology

Question 1

What is the most common form of anemia in children?

Answer 1

Iron deficiency anemia

Question 2

how common is iron deficiency anemia and deficiency

Answer 2

Deficiency: 30%
Anemia: Caucasion 3%, AA 15%

Question 3

Ssx of Fe deficiency anemia?

Answer 3

pallor
nail spooning
pica

Question 4

What should you ask when considering iron deficiency in infant?

Answer 4

Did they go to term?

Moms Fe status when pregnant?

Question 5

Standard of care if child is breastfed?

Answer 5

Iron supplementation at 6 months
Test at 9 months if concerned
Test at 12 months routine screening

Question 6

Sx of Fe deficiency

Answer 6

Neurologic dysfunciton

Question 7

Treat Iron deficiency?

Answer 7

Iron rich food

Supplement 1mg/kg/day Liquid iron: ferrous sulfate or glycinate

Question 8

When would you see infant with macrocytic normochromic andmia?

Answer 8

B12 or folate deficiency anemia if mother was deficient.

- uncommon

Question 9

When it looks like CBC should be iron deficient but ferritin is high, what do you suspect?

Answer 9

THink a hemoglobinapathies like thalassemia.

microcytic anemia

Question 10

Thalaassemia sx in general

Answer 10

Microcytic anemia
hemolysis
splenomegaly
bonychanges

Question 11

Difference between thalassemia A and B

Answer 11

Thalassemia A: 4 genes, if 0 = fatal

Thalassemia B: 2 genes, 0 = severe life threatening anemia.

Question 12

Complication of thalassemia?

Answer 12

Skeletal abnormalities
Growth retardation
CHF
gallstones
Iron overload

Question 13

Treatment for thalassemia

Answer 13

Folic acid

Question 14

Henoch-scholein purpura

Answer 14

systemic vasculitis involving small blood vessels of skin, GI tract joints and kidneys.

Question 15

What is Henoch-scholein purpura associated with?

Answer 15

Recent URI or strep

Question 16

Henoch-scholein purpura SSX

Answer 16

Petechial rash: feet, buttocks, elbows
Joint pain and swelling of hands head and feet
Hematuria
abdominal pain

Question 17

Henoch-scholein pururia is at high risk for what?

Answer 17

Interception***

Question 18

COmplications of heonoch scholein purpuria

Answer 18

• htn
• kideny disease
• bowel perforation, intussception, appendicitis

Question 19

Long term risk of H-S morbidity

Answer 19

Kidney finction: involvement has long term morbidity

- refer to nephrologists if 2+ protein

Question 20

short term risk of HS morbidity

Answer 20

GI tract disease significant morbidity short term

Question 21

Follow up for HS

Answer 21

Weekly then monthly bloodwork.

33% chance of recurrence in 6 weeks

Question 22

Hemophilia

Answer 22

bleeding disorder caused by absence or sever deficiency or defective functioning of plasma coagulation factors.
- cant make thrombin or thrombin

Question 23

Two types of hemophelia?

Answer 23

Hemophilia A: factor 8 most common

Hemophilia B: Factor 9 most dangerous

Question 24

How is hemophilia diagnosed

Answer 24

Prenatal dx chorionic villous sample/amniocentesis
cord blood
PT and PTT: prolonged bleeding time and easy bruisin

Question 25

Complications of hemophilia

Answer 25

Hemophilic arthropathy
life threatening hemorrhages
Refer to hematologist

Question 26

Lead poisoning:

Answer 26

most common pediatric environmental health problem with inorganic leat

Question 27

Treat H-S

Answer 27

NSAIDs

Steroids/immunosupressants

Question 28

How is led poisoning diagnosed

Answer 28

Lead>10ug/dl

CBC may have anemia

Question 29

COmplicaitons of lead poisoning

Answer 29

encephalopathy
coma
congnitive impairment
abdominal colic

Question 30

ssx of lead poisoning

Answer 30

anorexia,
abdominal pain
change in mental or development status

Question 31

Treatment for lead poisoning?

Answer 31

remove from lead source

chelation therapy: EDTA of DMSA: uncommon

Question 32

Hodgkin lymphoma

Answer 32

Malignant enlargement of lymph nodes characterized by a pleomorphic cellular infiltrate with multi-nucleated giant cell.

Question 33

Peaks of hodgkins lymphoma

Answer 33

Late 20’s

Late adulthood

Question 34

SSX of Hodgkins lymphoma

Answer 34

Painless lymphadenopathy, firm, immobile
Mediastinal mass
nonproductive cough
hepatosplenomegaly
fatique, anorexia weight loss
Fever, night sweats

Question 35

treatment for hodgkins lyphoma

Answer 35

Chemotherapy
radiation
DX with lymph note biopsy

Question 36

Non Hodgkins lymphoma: Non HL

Answer 36

malignant proliferation of cells of lymphocytic or histocytic lineage.
Third most common childhood malignancy.
related to EBV virus

Question 37

types of nonHL

Answer 37

Lymphoblastic : t cell

Large cell: B cell

Question 38

B cell lymphoma

Answer 38

Lump in neck
abnomal mass and pain
fever weight loss, fatigue

Question 39

T cell lymphoma Sx

Answer 39

mediastinal tumor,
chest pain, anxidty
bleeding or bruising

Question 40

Lymphoblastic lymphoma

Answer 40

mediatinal mass
cyanosis of face, swelling,
diaphoresis, stridor, wheezing

Question 41

Labs for lympomas

Answer 41

Lymphnode biopsy

bone marrow aspirate/biopsy

Question 42

Leukemia

Answer 42

malignant disorder lymphoblasts

Question 43

what is the most common cancer of childhood

Answer 43

Acute leukemia: 1 in 1700 children under 15

Question 44

SSX of leukemia

Answer 44

Thrombocytopenia
bone pain
fatigue/pallor
stridor, orthopenai
lymphadenopathy
hepatosplenomegaly

Question 45

labs for leukemia

Answer 45

CBC: Leukocytosis
Bone marrow:
Prognosis: