Hemo_Onco Flashcards
What type of anemia do iron deficient children have?
microcytic hypochromic anemia
What is the best approach for acute resuscitation in newborns with mod-severe dehydration?
bolus NS 20 ml/kg until stable
What are 2 major differences between immune thrombocytopenic purpura and acute lymphoblastic leukemia?
- ITP patients look well; ALL patients look sick
- ITP has normal WBC; ALL has neutropenia + 1
What is the classic sign of raised ICP?
Cushing’s triad
Because patients with SCA are at risk of stroke what yearly test should you perform?
transcranial doppler
How do you calculate the lower limit of MCV?
70 + age in years from 1-10 years old
Which of the following statements regarding acute lymphoblastic leukemia is NOT true?
a. treatment is risk-based
b. treatment consists of 3+ years of chemotherapy
c. CNS prophylaxis is necessary to prevent CNS relapse
d. Stem cell transplant is recommended in all children
d. Stem cell transplant is recommended in all children
How is iron deficiency anemia diagnosed and treated?
- dx: low ferritin
- tx: elemental Fe + Vit C
Raised ICP is most commonly caused by what?
hydrocephalus from tumor blockage
What is the diagnostic test of choice for acute lymphoblastic leukemia?
-Bone marrow aspirate
What are the common causes of high MCV, normocytic, or low MCV anemia?
high MCV = folate/Vit B12 deficiency
normocytic = ACD, acute blood loss
low MCV = iron deficiency anemia
What is the risk of correcting hyponatremia too fast?
central pontine myelonosis
What is the recommended dietary intervention for lead poisoning patients?
increase iron and calcium
What are the 3 major causes of mortality in infants?
Which of the 3 is the major cause of death in first year of life?
Which of the 3 is the major cause of death in teenagers/young adults?
- Septicemia = first year of life
- Acute Chest Syndrome = teens/young adults
- Stroke
If a patient presents with a headache over the occipital region that wakes him up at night and ataxia what are you concerned about?
CNS tumor
Which of the following should be corrected slower?
hyponatremia or hypernatremia
hypernatremia
What is the maintenance fluid of choice if child is >1 year old/10kg vs infant?
- > 1 yo/10kg = D5 NS + 20 mEq/L KCI
- infant = D5 1/2 NS + 20 mEq/L KCI
What is the classic sign of immune thrombocytopenic purpura?
petechiae
What is the most common complication of SCA?
Pain crisis
What is the risk of correcting hypernatremia too fast?
cerebral edema
You should define anemia based on what?
MCV
NOT reticulocyte count
How do you calculate the deficit volume for mod-severe dehydration?
- First 8 hrs = 50% deficit
- Next 16 hrs = 50% deficit
To prevent septicemia from occurring in patients with SCA what prophylaxis treatment is recommended and for how long?
Penicillin until 5 yo
What does Cushing’s triad consist of?
- Bradycardia
- HTN
- Respiratory irregularity
Calculate the fluid maintenance in a 24 kg child
4ml/kg/hr x 10kg)+(2ml/kg/hr x 10kg)+(1ml/kg/hr x 4kg) = 64ml/hr
T/F: IV maintenance fluids can sustain growth or recovery.
False
What % of water loss classifies dehydration as mild, moderate or severe in infants?
- mild = 5%
- moderate = 5-10%
- severe = 10-15%
What is the cause of aplastic crisis?
wipeout of RBC production d/t parovirus B12 infection
Which of the following treatment options is NOT recommended for immune thrombocytopenic purpura?
a. steroids
b IVIg
c. platelet transfusion
d. Anti-D globulin
c. platelet transfusion
Which of the following treatment options is the best for immune thrombocytopenic purpura IF the patient has the Rh + factor?
a. steroids
b IVIg
c. splenectomy
d. Anti-D globulin
d. Anti-D globulin
What medication can be given for recurrent severe pain crisis in SCA?
hydroxyurea
Not including acute resuscitation, what are the 3 components of rehydration for a patient with mod-severe dehydration?
- deficit replacement
- maintenance fluids
- replace ongoing losses
What % of water loss classifies dehydration as mild, moderate or severe in older children?
mild = 3 % moderate = 6 % severe = 9%
What classic symptom do you see in iron deficiency anemia in children?
Pica
How do you calculate fluid maintenance?
- First 10 kg = 4 ml/kg/hr
- Second 10 kg = 2 ml/kg/hr
- each additional kg = 1 ml/kg/hr
In a patient with SCA if he presents with fingers/toes of unequal length in adulthood what condition do you suspect he had as a child?
Dactylitis (Hand-foot syndrome)
What is the best approach to mild-mod dehydration correction?
oral rehydration with pedialyte
What lab values is a classic sign of acute lymphoblastic leukemia?
ANC will be rock bottom + 1 other CBC line will be down
What lab finding would have you concerned for aplastic crisis in a patient with SCA?
Reticulocyte index of 0 (or low)
It should be high
Hypernatremia should be corrected over how many hours?
48-72 hrs
