Hematology Flashcards
Iron def anemia etiology
rapid increase in body size
insuff of iron in diet
preterm
IDA sxs
pallor or spooning of nails
pica
IDA complications
neuro dysfxn with irritability, short attention span, poor scholastic performance
IDA Tx
ferrous sulfate or ferrous glycinate
increase iron rich foods (meat, dried fruit, beans, PB)
supplement iron 1mg/kg/day for infants exclusively breastfed past 6 mos
IDA Screening
9 mos, 5 years, 14 years
Thalassemia
unpaired globin chains cause hemolysis and splenomegaly
ineffective erythropoiesis causes hepatosplenomegaly and bony changes
short RBC lifespan
alpha Thalassemia
3 genes= silent carrier
2 genes= trait, Hb Bart, usu asx
1 gene= Hb H dz, SE Asia, mod microcytic anemia, splenomegaly
0 genes= hydrops fetalis, SE Asia, death in utero
beta Thalassemia
1 gene= mild anemia with significant hypochromic and microcystosis
0 genes= life threatening anemia apparent after 6 mos, severe hypochromic, microcytic anemia
* complications- skeletal abnormalities, growth retardation, CHF, gallstones, iron overload
Hemoglobin
9-12 g/dL in a/B trait
6-10 g/dL in Hb H dz
7-10 g/dL in B thalassemia intermedia
<5g/dL in B thalassemia major
Henoch-Scholein Purpura
immune mediated, systemic vasculitis of skin, GI tract, kidneys
assoc with strep throat
fever, HTN, purpuric rash in pressure-dep distribution
jt pain/swelling
nonpitting edema of scalp, periorbital, hands and feet
colicky abdominal pain
Henoch-Scholein Purpura labs
IgA elevated
UA: hematuria, proteinuria
Stool guiac
Ab US to screen for intussusception
Henoch-Scholein complications
HTN, kidney dz, intussusception, bowel perforation, appendicitis
Henoch-Scholein prognosis
excellent, 33% chance of recurrence
may have GI tract dz
renal involvement most sig sequalae
Henoch-Scholein Tx
analgesics, steroids
steroids/immunosuppressants if >50% crescentic glomerulonephritis
Hemophilia
def of factor VIII (A) or IX (B)
sex linked recessive
impaired thrombin and fibrin clotting/jt bleeding
Hemophilia Dx
prenatal- chorionic villous sampling
cord blood testing
suspect if long BT or unusual bleeding
Hemophilia labs
PT and PTT
factor VIII and IX assays
Hemophilia complications
arthropathy
intracranial bleeding
airway compromise
life threatening hemorrhages
*need to be under care of hematologist
Lead poisoning
ingestion of house dust, soil, paint chips
CDC: Pb > 10ug/dL
sxs: anorexia, ab pain, change in mental/developmental status
CBC may show anemia
Lead poisoning complications
acute encephalopathy
seizures, coma, death
metal retardation
anemia, ab colic
Lead poisoning Tx
remove lead source
chelation- EDTA or DMSA (if >45ug/dL)
supplement with Ca and Fe
redraw every 3-4 mos (if 10-19), every month if >20ug/dL
Hodgkin Lymphoma
enlargement of lymph nodes with infiltrate/multinucleated giant cells (Reed Sternberg)
peaks: late 20s (in US) and late adulthood
assoc with EBV
Hodgkin lymphoma sxs
painless LAD mediastinal mass w non productive cough or difficulty breathing hepatosplenomegaly fatigue, wt loss, anorexia fever, night sweats
Hodgkin lymphoma Tx
chemo and radiation
good prognosis
Non-Hodgkin lymphoma
Hx of EBV
B cell or T cell origin
Non-Hodgkin lymphoma B cell
fever, wt los, anorexia
lump in neck
ab mass with pain, swelling, N/V
Non-Hodgkin lymphoma T cell
mediastinal tumor with cough, hoarse, dyspnea, orthopnea, chest pain, anxiety, confusion, syncope
bleeding, bone pain, pallor, fatigue
Non-Hodgkin lymphoma labs
LN biopsy
BM aspirate and biopsy
ALL
most common CA of childhood
easy bruising- thrombocytopenia
bone pain, arthralgia- infiltration of BM
fatigue and pallor-anemia
stridor, orthopnea, SOB- mediastinal mass
LAD, hepatosplenomegaly
ALL labs
leukocytosis
neutropenia and thrombocytopenia
BM aspirate- lymphoblasts
ALL prognosis
95% remission
long term survival= 80%
