HEME-ONC Flashcards
At what point do screen babies for iron deficiency (MICROcytic) anemia? What do you see on labs?
12 months
Elevated TIBC, low MCV, low serum ferritin
What would you notice on PE with anemia?
Glossitis, angular stomatitis, koilonychia
What does basophilic stippling indicate?
Lead poisoning
How do you treat lead poisoning?
Chelating therapy
If labs show macro-ovalocytes, hypersegmented polymorphonuclear cells, and Howell-jolly bodies or elevated homocysteine – what diagnosis?
Folate deficiency (MACROcytic anemia >100 MCV)
Do children often have neuro sxs with folate deficiency? What about B12 deficiency?
No Neuro sxs or folate
B12 deficiency will have neuro sxs
If a child has facial swelling (chipmunk face) and on PE you note cardiac, hepatic, and endocrine abnormalities – what diagnosis? What lab finding?
Beta thalassemia Major
See Target Cells
What diagnosis presents with painful swelling in the hand and feet, and significant bone pain? What would you see on labs?
Sickle cell
See peripheral smear with sickle-shaped RBC’s
If a child has acute, severe, and debilitating pain – what diagnosis and what is occurring?
Sickle cell crisis
avascular necrosis → bone marrow infection
If a child is very easily bruised, and you noted significant swelling into the knee – that when aspirated is blood. What diagnosis?
Hemophilia A or B
If a young child has reccurent bleeding gums or epistaxis – or a young girl with significant menorrhagia – what diagnosis should you keep on your differentials?
Von Willebrand or Idiopathic thrombocytopenia purpura
How do you differentiate Von Willebran vs. Idiopathic thrombocytopenia purpura? Treatment?
Von Will = Normal platelet with vWF antigen. Tx = Desmopressin
ITP = ISOLATED decreased platelets without cause. Tx = Steroids or Rituximab
If you have 7 year old with frequent nose bleeds, bone pain, and frequent infections, what test do you get and what do you see?
CBC and you will see mildly elevated leukocytosis
Blood smear – you will see the younger/small nucleus with BLASTS
In AML, how would the patient appear?
Acute picture – Adults who have been exposed to chemo/radiation or has previously had CML
We know that in AML, we will see mainly lymphocytes, but what else might we see?
Auer Rods! Would indicate treatment with vitamin A
A 4 year-old boy is coming in for leg pain while walking. He has pallor of the conjunctiva, purpura, petechiae, and a palpable spleen. His lab results show a low WBC count, low hemoglobin, and low platelets. What is your differential Dx?
ALL
How do you treat ALL & AML?
Chemo
If WBC are VERY elevated, you order a smear that comes back negative, and you decide to order a Karyotype and it shows Philadelphia chromosome – what diagnosis?
Chronic myelogenous leukemia (CML)
A patient presents with PAINLESS lymphadenopathy (a supraclavicular node is visible). Their CBC comes back normal, but you want to biopsy the lymph node – it comes back with Reed Sternberg cells which are pathognomonic for?
Hodgkin’s lymphoma
What lymphoma typically presents with B symptoms?
Hodgkins
What lymphoma has the better prognosis?
Hodgkins
What else is associated with Hodgkins lymphoma?
Pel-Epstein fevers (cyclical fevers)
Their swollen lymph node that is non-tender, becomes tender when they drink alcohol
What else is associated with Non-Hodgkins lymphoma?
Burkitt’s lymphoma = has a “starry sky” pattern
What is the most common malignancy is infancy? What lab finding is present?
Neuroblastoma
Catecholamine secretion*
If an infant has a unilateral abdominal mass – what diagnosis and how do you treat?
Wilms tumor
Diagnose via CT NEVER biopsy
Treat with surgery & chemo
What is the most common bone cancer that appears as a sunburst?
osteosarcoma
What form of bone cancer is present in the long bones (leg pain), ribs, and flat bones (back pain)?What form of bone cancer is present in the long bones (leg pain), ribs, and flat bones (back pain)?
Ewing sarcoma
What is a rhabdomyosarcoma?
Soft tissue sarcoma; that will cause disturbance of normal body function
If a child does not have a red reflex, but instead has leukocoria (white papillary reflex) – what diagnosis?
Retinoblastoma
