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Pediatric EOR > Hematology > Flashcards

Hematology Flashcards

1
Q

Anemia is defined as __________ or ________

A

Low hemoglobin

Low hematocrit

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2
Q

Symptoms of anemia are a result of ___________

A

Decreased oxygen delivery to tissues

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3
Q

Core symptoms of all types of anemia

A 
Fatigue
Dyspnea on exertion
Palpitations
If severe:
Syncope and chest pain
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4
Q

Types of macrocytic anemia (MCV > 100)

A 
B12 Deficiency
Folate Deficiency
Alcoholism
Hypothyroidism
Liver disease
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5
Q

Types of microcytic anemia (MCV < 80)

A

Iron deficiency
Thalassemia
Anemia of chronic dz
Sideroblastic anemia

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6
Q

Types of normocytic anemia (MCV 80-100)

A

Blood loss
Hemolysis
Anemia of chronic dz

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7
Q

How does a pt with vitamin B12 deficiency present?

A

Neurological symptoms

Peripheral neuropathy most common

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8
Q

Lab values for vitamin B12 deficiency

A

Low B12 level
High MMA
May also see: elevated iron, indirect bilirubin and LDH

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9
Q

Vitamin B12 deficiency can be secondary to medication such as:

A

Metformin
PPis
Cimetididne

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10
Q

Treatment for vitamin B12 deficiency

A

Vitamin B12 replacement

IM preferred if severe neurological problems

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11
Q

Treatment for folate deficiency

A

Folic acid

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12
Q

A patient with iron deficiency will present with

A

Blood loss

GI or menses

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13
Q

Lab values for iron deficiency

A 
Low serum iron
Low ferritin
High total iron binding capacity
High RDW
Elevated platelet count
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14
Q

Treatment for iron deficiency

A

Always look for a cause!

Ferrous sulfate

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15
Q

Complications of ferrous sulfate

A

Can turn stools black but will have negative guaiac stools

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16
Q

Thalassemia is characterized by hemoglobin having reduced

A

Alpha or beta chains

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17
Q

Thalassemia will have _________ or __________ on peripheral smear

A

Target cells

Tear-drop shaped cells

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18
Q

Beta thalassemia is diagnosed with

A

Electrophoresis

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19
Q

Treatment for beta thalassemia

A

Transfusions

Iron chelation

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20
Q

Lab values for anemia of chronic disease

A

Low serum iron, low iron binding capacity, normal ferritin

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21
Q

Most common cause of hemolysis normocytic

A

Sickle cell disease

22
Q

Ultimate complications of anemia

A

Arrhythmias
MI
CHF

23
Q

Malignancy of lymphoid stem cells in bone marrow, migrating to the lymph nodes, spleen, liver and other organs

A

Acute Lymphocytic Leukemia (ALL)

24
Q

Most common childhood malignancy, peaking between ages 3-7 y/o

A

Acute lymphocytic leukemia (ALL)

25
Q

Children with _____________ have increased rates of ALL

A

Down syndrome

26
Q

Signs/symptoms of ALL

A
  1. Pancytopenia symptoms: fever, fatigue, lethargy. Bone pain
  2. CNS symptoms: HA, neck stiffness, visual changes, vomiting
27
Q

Physical exam with ALL

A

Pallor, fatigue, petechiae, bruising, hepatosplenomegaly, lymphadenopathy, +/- mediastinal mass

28
Q

Diagnosis of ALL

A

Bone marrow - hypercellular with >20% blasts, anemia, thrombocytopenia

29
Q

Management of ALL

A 
Oral chemo (> 90% remission)
Stem cell transplant if relapse
30
Q

Most common inherited bleeding disorder (autosomal dominant)

A

Von Willebrand Disease

31
Q

Characterized as a defect or deficiency in a factor that helps platelets stick to sites of endothelial injury

A

Von willebrand disease

32
Q

Signs/symptoms of von willebrand diseasee

A

Bleeding
Gingival bleeding, epistaxis, menorrhagia and skin bruising
NSAIDs/Aspirin may precipitate an episode

33
Q

Diagnosis of von willebrand disease

A

Normal platelet count
Normal PT
Von willebrand factor antigen - decreased
Von willebrand factor activity - decreased
Factor VIII activity - decreased
If all abnormal, perform RIPA

34
Q

First line treatment for von willebrand disease

A

Desmopressin

Second line: von willebrand factor concentrate

35
Q

Reed sternberg cells pathognomonic - B cell proliferation with bilobed or multilobar nucleus “owl eye”

A

Hodgkin’s Disease Lymphoma

36
Q

Lymph node involvement with Hodgkin’s Disease lymphoma

A

Upper lymph node involvement

Neck, axilla, shoulder, chest (mediastinum)

37
Q

With Hodgkin’s disease lymphoma, sometimes you will see pts with painful lymph nodes with

A

EtOH consumption

Although pts present with painless lymph nodes usually

38
Q

Associated symptoms with Hodgkin’s Disease lymphoma

A

Fever
Weight loss
Anorexia
Night sweats

39
Q

Pel Ebstein Fever

A

Intermittent cyclical fevers x 1-2 weeks

Hodgkin’s lymphoma

40
Q

40% of Hodgkin’s Lymphoma is associated with

A

Epstein-Barr Virus

41
Q

Hodgkin’s Lymphoma has an __________ 5 year cure

A

Excellent

42
Q

Group of inherited (x-linked recessive [male]) bleeding disorders

A

Hemophilia

43
Q

Factor VIII Deficiency

A

Hemophilia A

44
Q

Factor IX Deficiency

A

Hemophilia B or Christmas disease

45
Q

Signs/symptoms of hemophilia

A

Pt who is bleeding into joints, muscles, or GI tract. First episode can occur anywhere from first few months of life up until age 4

46
Q

Diagnosis of hemophilia

A

Normal platelet count
Normal PT
Prolonged aPTT
When pts plasma combined with normal plasma, aPTT will correct itself
Confirmation done by ordering specific assay

47
Q

Treatment of hemophilia

A

Hemophilia A - Desmopressin
Hemophilia B - specific clotting factor
Factor XI Deficiency - no prophylactic therapy needed

48
Q

Lead poisoning causes cell death, shortens the lifespan of RBCs and leads to:

A

Acquired sideroblastic anemia

49
Q

Signs/symptoms of lead poisoning

A 
Abdominal pain with constipation
Neurologic symptoms (ataxia, fatigue, learning disabilities, coma, shock)
Anemia symptoms, metabolic acidosis
50
Q

Diagnosis of lead poisoning

A
  1. Increased serum lead, increased serum Fe, decreased TIBC, increased ferritin
  2. Peripheral smear: microcytic, hypochromic anemia with basophilic stippling
  3. Ringed sideroblasts in bone marrow
  4. XR: lead lines at metaphyseal plates
51
Q

Management of lead poisoning

A

Remove source of lead. Chelation therapy may be needed if severe (Succimer)

Pediatric EOR (10 decks)

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