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Pediatrics > Hematology > Flashcards

Hematology Flashcards

1
Q

How long will physiologic anemia of infancy lasts?

A

8 to 12 weeks

not lower than 11g/dL

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2
Q

Minimal level of Hgb in Physiologic anemia of prematurity

A

7-9 g/dL

More extreme and rapid decline

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3
Q

[Anemia: Causes]

Low Hgb
Retic <2.5
Normocytic

A

Bone marrow damage

  1. Infiltration
  2. Aplasia
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4
Q

[Anemia: Causes]

Low hgb
Retic <2.5
Micro/Macrocytic

A
  1. IDA
  2. Thalassemia
  3. Folate deficiency
  4. B12 deficiency
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5
Q

[Anemia: Causes]

Low Hgb
Retic > 2.5
Hemolysis/Hemorrhage

A
  1. Autoimmune
  2. Membrane defect
  3. Metabolic
  4. Hemoglobinopathy
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6
Q

[Anemia: Causes]

Microcytic anemia
MCV <80

A
  1. Thalassemia
  2. Iron deficiency
  3. Lead poisoning
  4. Sideroblastic anemia
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7
Q

[Anemia: Causes]

Normocytic
MCV 80-100

A
  1. Hypothyroidism
  2. Uremia
  3. Bone marrow failure (aplastic anemia)
  4. Anemia of chronic
    Disease

HUBAd

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8
Q

[Anemia: Causes]

Macrocytic
MCV>100

A
  1. Folate deficiency
  2. Vitamin B12 deficiency
  3. Drug and alcohol-induced anemia
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9
Q

[IDA vs Thalassemia]

Microcytic
Hypochromic
Normal RDW
Retic <2.5

A

Thalassemia

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10
Q

[IDA vs Thalassemia]

Microcytic
Hypochromic
Elecated RDW
Retic <2.5

A

IDA

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11
Q

Most common hematologic disease of infancy and childhood

A

IDA

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12
Q

Most common age group affected by IDA

A

9-24 months of age

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13
Q

What is the most important sign of IDA

A

Pallor

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14
Q

[IDA]

level of Hgb that compensatory mechanisms start to appear, but no symptoms

A

6-10mg/dL

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15
Q

[IDA]

Level of Hgb at which irritability and anorexia appears along with compensator ymechanisms

A

5mg/dL

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16
Q

What is the laboratory feature of IDA?

A 
Microcytic
Hypochromic
low retic
high RDW
low serum iron
Low serum ferritin
high TIBC
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17
Q

[Prevention of anemia]

Premature infants

A

7.5mg OD for 3 months

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18
Q

[Prevention of anemia]

4-11 months

A

15mg OD for 3 months

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19
Q

[Prevention of anemia]

1-5 years old

A

30mg OD for 3 months

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20
Q

[Prevention of anemia]

Adolescents

A

Iron 60mg + Folic acid 400mcg

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21
Q

[Treatment of anemia]

How will you treat anemia

A

3-6 mg/kg/day elemental iron in 2-3 divided doses

Max 150 to 200mg/day

For 2-3 months until blood value normalizes

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22
Q

[Treatment of anemia]

What is the expected rise in Hgb after treatment?

A

Hgb 0.1 to 0.4 g/dL/day

23
Q

[Response to iron therapy]

subjective improvements in patients happen in

A

12-24 hours

24
Q

[Response to iron therapy]

Initial bone marrow response

A

26 to 28 hours

25
Q

[Response to iron therapy]

Reticulocytosis

A

28 to 72 hours

26
Q

[Response to iron therapy]

Increasing Hgb

A

4 to 30 days

27
Q

[Response to iron therapy]

repletion of iron stores

A

1-3 months

28
Q

What are the composition of the normal tetramer of Hgb?

A
  1. 2 alpha

2. Beta

29
Q

[Alpha Thalassemia]

1/4 foci

A

asymptomatic

30
Q

[Alpha Thalassemia]

2/4 foci

A

mild anemia (thalassemia trait)

31
Q

[Alpha Thalassemia]

3/4 foci

A

hemoglobin H

splenomegaly, increased B4

32
Q

[Alpha Thalassemia]

4/4 foci

A

hydrops fetalis

33
Q

What is the clinical picture of alpha thalasemia

A
  1. Decreased Retic
  2. Microcytic, hypochromic RBCs
  3. Normal RDW
  4. Target cells and Heinz bodies on PBS
34
Q

[Beta thalassemia]

no beta globin production
anemia at 6 months

A

Beta thalassemia major

35
Q

What is the test to definitely diagnose electrophoresis?

A

Hemoglobin electrophoresis

Result: increased HbF, HbA2

36
Q

What is the characteristic PBS result in Hemolytic anemia?

A

Normocytic
Normochromic
increased retic

37
Q

What blood test will be useful to establish spherocytosis

A

osmotic fragility test confirms the presence of fragile sphere

38
Q

What surgical procedure can cure spherocytosis?

A

Splenectomy

Folate supplementation can be also helpful

39
Q

What are the complications of Sickle cell disease

A
  1. Vasoocclusive crisis
  2. Aplastic crisis
  3. Splenic sequestration crisis
  4. Priapism
  5. Stroke
  6. Leg ulcers
  7. Acute chest syndrome
40
Q

Diagnostic cranial xray in patients with Sickle cell disease

A

Crew cut hair or hair on end appearance

41
Q

What are the drugs used to treat Sickle Cell disease

A

Hydroxyurea

analgesic + hydration for acute crises

Folate stimulation

42
Q

Most common hereditary bleeding disorder

A

von Willebrand disease

43
Q

Most common and most serious congenital coagulation factor deficiency

A

Hemophilia A

44
Q

Most common hereditary hypercoaguable disorder

A

Factor V Leiden

45
Q

Hallmark of hemophilia

A

Prolonged bleeding

46
Q

Earliest joint hemorrhages in children

A

Ankles

47
Q

____ assay that measures vWF antigen levels and activity

A

Ristocetin cofactor assay

48
Q

Treatment for mild vWF disease

A

Desmopressin

causes release of vWF from endothelial stores

49
Q

Treatment for severe vWF disease

A

Factor VIII concentrates which contain high vWF Ag

50
Q

[Diagnose]

PT: Normal
PTT: increased
BT: Normal
PC: Normal

A

Hempophilia A and B

51
Q

[Diagnose]

PT: Normal
PTT: inc
BT: inc
PC: Normal or dec

A

vWD

52
Q

[Diagnose]

PT: Normal
PTT: Normal
BT: Increased
PC: Normal

A

ITP

53
Q

[Diagnose]

PT: increased
PTT: normal to inc
BT: Normal
PC: Normal

A

VitK deficiency

54
Q

[Diagnose]

PT: inc
PTT: inc
BT: inc
PC:dec

A

DIC

Pediatrics (15 decks)

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