Hematology Flashcards
What is the most common form of anemia in children?
Iron deficiency anemia
how common is iron deficiency anemia and deficiency
Deficiency: 30%
Anemia: Caucasion 3%, AA 15%
Ssx of Fe deficiency anemia?
pallor
nail spooning
pica
What should you ask when considering iron deficiency in infant?
Did they go to term?
Moms Fe status when pregnant?
Standard of care if child is breastfed?
Iron supplementation at 6 months
Test at 9 months if concerned
Test at 12 months routine screening
Sx of Fe deficiency
Neurologic dysfunciton
Treat Iron deficiency?
Iron rich food
Supplement 1mg/kg/day Liquid iron: ferrous sulfate or glycinate
When would you see infant with macrocytic normochromic andmia?
B12 or folate deficiency anemia if mother was deficient.
- uncommon
When it looks like CBC should be iron deficient but ferritin is high, what do you suspect?
THink a hemoglobinapathies like thalassemia.
microcytic anemia
Thalaassemia sx in general
Microcytic anemia
hemolysis
splenomegaly
bonychanges
Difference between thalassemia A and B
Thalassemia A: 4 genes, if 0 = fatal
Thalassemia B: 2 genes, 0 = severe life threatening anemia.
Complication of thalassemia?
Skeletal abnormalities Growth retardation CHF gallstones Iron overload
Treatment for thalassemia
Folic acid
Henoch-scholein purpura
systemic vasculitis involving small blood vessels of skin, GI tract joints and kidneys.
What is Henoch-scholein purpura associated with?
Recent URI or strep
Henoch-scholein purpura SSX
Petechial rash: feet, buttocks, elbows
Joint pain and swelling of hands head and feet
Hematuria
abdominal pain
Henoch-scholein pururia is at high risk for what?
Interception***
COmplications of heonoch scholein purpuria
- htn
- kideny disease
- bowel perforation, intussception, appendicitis
Long term risk of H-S morbidity
Kidney finction: involvement has long term morbidity
- refer to nephrologists if 2+ protein
short term risk of HS morbidity
GI tract disease significant morbidity short term
Follow up for HS
Weekly then monthly bloodwork.
33% chance of recurrence in 6 weeks
Hemophilia
bleeding disorder caused by absence or sever deficiency or defective functioning of plasma coagulation factors.
- cant make thrombin or thrombin
Two types of hemophelia?
Hemophilia A: factor 8 most common
Hemophilia B: Factor 9 most dangerous
How is hemophilia diagnosed
Prenatal dx chorionic villous sample/amniocentesis
cord blood
PT and PTT: prolonged bleeding time and easy bruisin
Complications of hemophilia
Hemophilic arthropathy
life threatening hemorrhages
Refer to hematologist
Lead poisoning:
most common pediatric environmental health problem with inorganic leat
Treat H-S
NSAIDs
Steroids/immunosupressants
How is led poisoning diagnosed
Lead>10ug/dl
CBC may have anemia
COmplicaitons of lead poisoning
encephalopathy
coma
congnitive impairment
abdominal colic
ssx of lead poisoning
anorexia,
abdominal pain
change in mental or development status
Treatment for lead poisoning?
remove from lead source
chelation therapy: EDTA of DMSA: uncommon
Hodgkin lymphoma
Malignant enlargement of lymph nodes characterized by a pleomorphic cellular infiltrate with multi-nucleated giant cell.
Peaks of hodgkins lymphoma
Late 20’s
Late adulthood
SSX of Hodgkins lymphoma
Painless lymphadenopathy, firm, immobile Mediastinal mass nonproductive cough hepatosplenomegaly fatique, anorexia weight loss Fever, night sweats
treatment for hodgkins lyphoma
Chemotherapy
radiation
DX with lymph note biopsy
Non Hodgkins lymphoma: Non HL
malignant proliferation of cells of lymphocytic or histocytic lineage.
Third most common childhood malignancy.
related to EBV virus
types of nonHL
Lymphoblastic : t cell
Large cell: B cell
B cell lymphoma
Lump in neck
abnomal mass and pain
fever weight loss, fatigue
T cell lymphoma Sx
mediastinal tumor,
chest pain, anxidty
bleeding or bruising
Lymphoblastic lymphoma
mediatinal mass
cyanosis of face, swelling,
diaphoresis, stridor, wheezing
Labs for lympomas
Lymphnode biopsy
bone marrow aspirate/biopsy
Leukemia
malignant disorder lymphoblasts
what is the most common cancer of childhood
Acute leukemia: 1 in 1700 children under 15
SSX of leukemia
Thrombocytopenia bone pain fatigue/pallor stridor, orthopenai lymphadenopathy hepatosplenomegaly
labs for leukemia
CBC: Leukocytosis
Bone marrow:
Prognosis:
