Lecture 5: Pediatric Anemia Flashcards

1
Q

What is the effect of anemia on the oxygen dissociation curve, 2,3-DPG concentration with RBC’s, pH, and temperature?

A
  • Curve shifts to the RIGHT
  • Concentration of 2,3-DPG and temperature ↑↑↑
  • pH
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2
Q

List 5 clinical signs and symptoms often seen in patients with anemia.

A
  • Pallor
  • Sleepiness
  • Irritability
  • Decreased exercise tolerance
  • Flow murmur**
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3
Q

Which red cell lab value represnts the mean value of the volume of individual RBC’s in the sample?

A

MCV (mean corpuscular volume)

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4
Q

Which red cell lab value represents the grams of Hgb per 100mL of RBC’s?

A

MCHC (mean corpuscular hemoglobin concentration)

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5
Q

Which red cell lab value represents the average content (mass, weight) of Hgb per RBC?

A

MCH (mean corpuscular hemoglobin)

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6
Q

Which red cell value is used to characterize an anemia as being hypochromic, normochromic, or hyperchromic?

A
  • MCHC: ≤32 g/dL = hypochromic
  • MCHC: 33-34 g/dL = normochromic
  • MCHC: ≥35 g/dL = hyperchromic
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7
Q

Microcytic vs. macrocytic anemias in a pediatric patient is based on an MCV of what percentile for age, race, and sex?

A
  • Microcytic = ≤2.5th percentile
  • Macrocytic = ≥97.5th percentile
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8
Q

What are the 5 principle features of intravascular hemolysis?

A
  • Anemia
  • Hemogloniuria
  • Hemoglobinemia
  • Hemosiderinuria
  • Jaundice
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9
Q

What does a low or low-normal number of reticulocytes in pt with anemia indicate?

A
  • Inadequate bone marrow response
  • Either relative BM failure or ineffective erythropoiesis (not enough building blocks)
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10
Q

At what age do children hit a physiologic nadir for values of hematocrit and hemoglobin?

A

2 months of life

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11
Q

What type of anemia and other lab values will be seen in neonatal immune hemolytic anemia due to ABO or Rh incompatibility?

A
  • Normocytic anemia
  • (+) direct coombs test
  • indirect bilirubin
  • reticulocyte count
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12
Q

What type of anemia and reticulocyte count will be seen in congenital infection with Parvovirus B19?

A

Normocytic anemia w/ ↓ reticulocyte count

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13
Q

What type of anemia and reticulocyte count will be seen in Diamond-Blackfan syndrome; what is this disorder caused by?

A
  • Macrocytic anemia with ↓ reticulocyte count
  • Congenital PURE red cell aplasia resulting from ↑ apoptosis in erythroid precursors
  • 30% have other abnormalities; average age of dx is 3-months-old
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14
Q

What is the most common inherited form of aplastic anemia?

A

Fanconi anemia

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15
Q

What type of anemia, reticulocyte count, and other lab values are indicative of Fanconi anemia?

A
  • Macrocytic anemia and reticulocytopenia + thrombocytopenia + leukopenia
  • ↑ susceptibility of progenitor cells in BM leads to ↑ apoptosis
  • Progresses to pancytopenia (may not see sx’s until 10 y/o)
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16
Q

How is the anemia of iron-deficiency anemia classified and what is the RDW count + peripheral smear findings?

A
  • Microcytic hypochromic anemia w/ ↑ RDW
  • Peripheral smear = target cells + hypochromic microcytes
17
Q

What is the Mentzer index and how can it be used to differentiate iron deficiency anemia from beta-thalassemia?

A
  • Mentzer index = MCV/RBC count in millions
  • If, >13 = iron deficiency anemia is more likely
  • If, <13 = beta-thalassemia is more likely
18
Q

How is the anemia seen with lead poisoning classified and what is seen on peripheral smear?

A
  • Microcytic, hypochromic anemia
  • Peripheral smear = basophilic stippling
19
Q

What type of hemolysis is characteristic of G6PD deficiency; inheritance pattern; peripheral smear findings?

A
  • Causes episodic hemolysis
  • X-linked recessive
  • Heinz bodies and bite cells