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Pediatric Rotation > Hematology > Flashcards

Hematology Flashcards

1
Q

What is the threshold of defining anemia?

A

HCT or HGB at or below the 2.5th percentile for age, race, and sex (typically somewhere below 11-11.5)

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2
Q

What are causes of anemia of neonates to 3 months?

A

Hyperbilirubinemia
Chronic intrauterine blood loss
Thalassemia

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3
Q

What are causes of anemia from 3 months to 6 months?

A

Sickle cell

Thalassemias

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4
Q

What are causes of anemia from those greater than 6 months?

A

Nutritional deficiencies such as iron deficiency anemia

-consider menses in females

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5
Q

In healthy term infants, what is the hemoglobin level?

A

HIGH

>14 g/dL

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6
Q

When does the the hemoglobin in healthy term infants drop?

A

6-9 weeks (11g/dL)

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7
Q

What do pencil poikilocytes, target cells, hemoglobin H or F indicate?

A

Thalassemia

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8
Q

What do pencil poikilocytes, microcytic hypo chromic smear and low serum ferritin indicate?

A

Iron deficiency anemia

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9
Q

What do bite cells, Heinz bodies, multiple nucleated RBCs, Red blood agglutination indicate?

A

Hemolytic anemia (G6PD)

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10
Q

What do Howell-Jolly bodies indicate?

A

Splenic disorders

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11
Q

What does basophilic stippling indicate?

A

Lead poisoning

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12
Q

What is the most common inherited bleeding disorder?

A

Von Willebrands disease

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13
Q

What is the function of vWF?

A

Aggregates PLTs and prolongs the half life of F. VII

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14
Q

What is Type 1 vWB disease? And how does it present in patients?

A

The pt does not make sufficient VWF quantity; they present with mild to moderate PLT-type bleeding (skin and mucosal)

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15
Q

What is Type 2 vWB disease? And how does it present in patients?

A

qualitative defect in vWF; moderate to severe bleeding that presents in childhood or adolescence

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16
Q

What lab values diagnose vWB disease?

A 
PLT normal or decreased 
PT, Fibrinogen is normal 
PTT normal or prolonged 
Bleeding time is prolonged 
*Depressed vWF activity
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17
Q

What is the tx for vWF disease?

A

DDVAP
Antifibrinolytics
Cryoprecipitate if severe

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18
Q

What is the most common childhood cancer?

A

Acute Leukemia

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19
Q

A child is presenting with hepatosplenomegaly, anorexia, lymphadenopathy (nontender, firm, rubbery), gingival hyperplasia, abnormal bruising, and musculoskeletal pain. Lab results reveal pancytopenia. How do you confirm your suspected diagnosis?

A

Bone marrow biopsy and aspiration : >20% blasts

20
Q

A child is presenting with hepatosplenomegaly, anorexia, lymphadenopathy (nontender, firm, rubbery), gingival hyperplasia, abnormal bruising, and musculoskeletal pain. Lab results reveal pancytopenia. There are elevated serum phosphates as well. What is the best treatment?

A

Chemotherapy (Vincristine) + steroids

*Once in remission, a bone marrow transplant should be performed

21
Q

What is the most common cancer in the 15-19 year age group?

A

Hodgkin Lymphoma

22
Q

A 16 year old patient presents with painless cervial lymphadenopathy. She has a fever, has lost weight, and complains of drenching night sweats and pruritis. How would you diagnose this patient?

A

Lymph node biopsy = REED-STERNBERG CELLS

23
Q

What is stage III Lymphoma?

A

Lymph node region involved on both sides of the diaphram

24
Q

A 16 year old patient presents with painless cervial lymphadenopathy. She has a fever, has lost weight, and complains of drenching night sweats and pruritis. A biopsy reveals Reed-Sternberg cells. What is the treatment for this patient?

A

If caught early, in stage 1: radiation

If 2+ : radiation + Stanford 5 Chemo

25
Q

Which type of cancer typically presents as a high grade cancer, such as: tamponade, vena cava obstruction, intestinal obstruction, airway obstruction?

A

Non-Hodgkin lymphoma

26
Q

How do you diagnose Non-Hodgkin lymphoma?

A

Lymph node biopsy
Elevated uric acid
Elevated LDH

27
Q

What is the tx for Non-Hodgkin lymphoma?

A

Radiation, Standord 5

Bone marrow transplant if remission is acheived

28
Q

What is the treatment for Hemophilia A?

A 
F. VIII concentrates (Cryoparticipate) 
Recombinant VIII
DDVAP
Antifibrinolytic agents 
Cox 2 inhibitors
29
Q

What do you want to avoid in patients with Hemophilia A?

A

Aspirin–it prolongs bleeding

30
Q

What is Hemophilia A?

A

Congenital deficiency of F. VIII

X linked recessive inheritance

31
Q

If an infant experiences “spontaneous” bleeding into joints, soft tissues or other locations–what should you suspect?

A

Hemophilia A

-as adults have significant joint disabilities

32
Q

What lab values are consistent with Hemophilia A?

A 
Bleeding time normal 
PT normal 
Fibrinogen normal 
PTT prolonged*
Low factor VIII 
Normal vWF
33
Q

If a patient with mild Hemophilia A/B is bleeding during a dental procedure, what is the best treatment?

A

Antifibrinolytics

34
Q

What is Hemophilia B?

A

Congenital deficiency of factor IX

X linked recessive

35
Q

What should you watch out for with Hemophilia B children?

A

They present the exact same way as a Hemophilia A patient

36
Q

What lab values diagnoses Hemophilia B?

A 
Low factor IX,
vWF normal 
PTT prolonged 
PT normal 
Bleeding time normal 
Fibrinogen normal
37
Q

What is the tx for Hemophilia B?

A

FFP (Pt receives all other clotting factors as 9 and can be more prone to clotting)

38
Q

If a patient with mild Hemophilia A/B has arthritis, what is the best treatment?

A

COX 2 inhibitor

39
Q

An Ashkenazi Jew has just has a lap chole and has had some mild prolonged bleeding. Based on this, what is the patients genetic condition?

A

Factor XI deficiency
Hemophilia C
Autosomal recessive

40
Q

If a patient has low XI, what can you expect their PTT to be? Normal or prolonged?

A

Prolonged

41
Q

What is the tx for Hemophilia C?

A

FFP and Amicar (fibrinolytics)

42
Q

What sxs are associated with lead poisoning?

A

Anemia
Hearing loss
Peripheral neuropathy
*decreased IQ and cognitive deficiency

43
Q

At higher levels, what do you see with lead poisoning?

A

Seizures and encephalopathy

44
Q

When does lead screening take place?

A

12 months

45
Q

At what level on a finger stick is a formal blood draw required?

A

over 5

46
Q

At high levels, what is the tx for lead poisoning?

A

Chelation

Pediatric Rotation (7 decks)

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