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PNP Boards > Heme > Flashcards

Heme Flashcards

1
Q

Causes of anemia in infants

A 
Physiologic
Blood loss
Immune hemolytic disease
Congenital infection
Congenital hemolytic process
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2
Q

Causes of anemia in kids

A

More likely acquired
Iron deficiency
Blood loss

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3
Q

Causes/ labs for microcytic anemia

A

Iron deficiency or thalassemia
Low MCV count
Low RDW with iron deficiency

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4
Q

Causes of normocytic anemia

A

Hemolytic anemia blood loss infection meds chronic disease

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5
Q

Causes/labs in macrocyclic anemia

A

High MCV
Meds
B12 or folate deficiency
Hypothyroidism

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6
Q

Aplastic anemia

A

Rare life threatening failure of hematopoesis leading to bone marrow aplasia and pancytopenia

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7
Q

S/sx of pancytopenia

A

Bleeding parlor headache fatigue tachycardia petechia purpura echymosis jaundice and infection

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8
Q

Lab findings of aplastic anemia

A

CBC shows pancytopenia
Low or no retic count
No evidence of malignancy

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9
Q

Beta thalassemia

A

Chronic hemolytic anemia, iron overload and ineffective erythropoiesis

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10
Q

Beta thalassemia presentation

A

Pallor irritability ftt diarrhea hepatosplenomegaly jaundice and bone deformities in the face
Severe microcytic hypochromic anemia with increased RBCs

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11
Q

Tx of beta thalassemia

A

Blood transfusions very often

High risk of iron overload may need chelation

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12
Q

G6PD deficiency triggers

A

Fava bean ingestion, infection, drug exposure

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13
Q

G6PD presentation

A

Fever nausea abdominal pain diarrhea hemoglobinuria jaundice pallor tachycardia hepatosplenomegaly
Severe anemia increased wbc poikilocytes increased ret count

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14
Q

Vado occlusive crisis s/sx

A

Tissue ischemia leads to severe pain and death of vascular beds
Dactylitis, chest head and back pain

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15
Q

Management of vaso occlusive crisis

A

Adequate hydration, nsaids, opiods and encouraging adequate ventilation

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16
Q

Anti microbial of choice in an acute infection with sickle cell

A

Penicillin, often already on prophylaxis

17
Q

Acute chest

A

Occurs in sickle cell disease

Ischemia/infarction of the lung, may develop pleural effusion

18
Q

Acute chest tx

A

Broad spectrum abx
Exchange or prbc infusion
Respiratory support

19
Q

When to screen for stroke in a sickle cell pt

A

Around age 2-16

*occurs in 7-10% of pts

20
Q

Splenic sequestration

A

Life threatening complication of sickle cell
Can lead to hypovolemic shock
Weakness pallor abdominal distension pain and splenimegaly

21
Q

Causes of DIC

A

Infection trauma ards ecmo and hematologist malignancy

22
Q

Lab findings in DIC

A

Thrombocytopenia prolonged Pt and ptt and prolonged d dimer*

23
Q

Hus triad

A

Thrombocytopenia hemolytic anemia and organ damage (often kidneys and brain)

24
Q

Most common infection in hus

A

Shiga toxin E. coli

25
Q

Hus symptoms

A

Abdominal pain watery/bloody diarrhea fever lethargy irritability and vomiting pallor petechiae hematites oliguria and hypertension

26
Q

ITP

A

Isolated thrombocytopenia with no other causes

27
Q

Henoch Schnlein Purpura presentation

A

Immune mediated small vessel vasculitis
Rash, pain, swelling
Hematuria proteinuria and hypertension diffuse abdominal pain
Palpable purpura arthralgia acute arthritis

28
Q

Hemophilia

A

Hereditary x linked recessive chromosomal disease
Factor 8 or 9 deficiency
Clotting disorder

29
Q

Hemophilia tx/prevention

A

Replace missing clotting factor
Prbc ffp and cryo transfusions
Ddavp for moderate bleeding
Education on prevention

30
Q

Von willebrand

A

Deficiency in vonwillebrand protein

Often diagnosed later in life

31
Q

Most sensitive study for embolic disorders

A

CT agnio

32
Q

Why to give ffp

A

Replaces coagulation factors

Dose 10-15 ml/kg

33
Q

Why to give cryo

A

Contains fibrinogen factor 8, 13 vonwillebrand factor and fibronectin
Given when fibrinogen is < 100
Give 1 unit per 5-10 kg of body weight

34
Q

Diagnostic for sickle cell anemia

A

Hemoglobin electropheresis

35
Q

Acute hemolytic reaction

A

Transfusion reaction related to hemolysis secondary to ABO incompatibility
Fever chills lumbar pain shock dyspnea hemoglobinuria chest pain DIC

36
Q

TACO

A

Circulatory overload post transfusion

Resp distress, hypoxia hypertension

37
Q

TRALI

A

Immune response post transfusion that leads to alveolar injury
6 hours post

PNP Boards (17 decks)

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