Newman: Pediatric Anemia

Question 1

What causes a right-shift in the O2-dissociation curve?

Answer 1

1. Decrease pH (increase H+ ions)
2. Increase CO2
3. Increase 2,3 DPG
4. Increase temp

Question 2

Pallor, sleepiness, irritable, decrease in XRCISE tolerance, flow murmur are clinical symptoms in anemia not seen until when?

Answer 2

Hgb is less than 7-8

Question 3

NL MCHC

Answer 3

33-34

Question 4

Decrease reticulocyte count can be due to

Answer 4

1. BM failure
2. Ineffective erythropoeisis

Question 5

Increased reticulocyte count is due to

Answer 5

Adequate BM response to anemia:

• 1. Hemolysis
• 2. Sequestration
• 3. Blood loss (bleeding)

Question 6

Causes of Anemia in neonates

Answer 6

1. Blood loss
2. Immune hemolytic anemia
3. Congenital hemolytic anemia (G6PD and PK def)
4. Infection: Parvovirus 19
5. Diamond-Blackfan Syndrome
6. Fanconi syndrome

Question 7

Immune hemolytic anemia in neonates is commonly due to what?

Signs/symptoms?

Answer 7

AutoAb form against RBC => extravascular hemolysis

Examples: ABO incompatibility** and Rh incompat.

• 1. • direct Coombs test
• 2. Increase indirect BR
• 3. Increase reticulocyte count
• 4. Normocytic anemia

Question 8

What is Diamond Blackfan Syndrome?

Answer 8

Example of pure RBC aplasia => destruction of erythroid precursors

• Macrocytic anemia (>100)
• Decrease reticulocyte count

Question 9

What is Fanconi anemia?

Answer 9

MC form of inherited aplastic anemia

AR/X-linked disorder that causes a problem in DNA repair => apoptosis of HSC in the BM => panctopenia

Question 10

Findings in Fanconi anemia

Answer 10

1. Macrocytosis
2. Pancytopenia: reticulocytopenia, thrombocytopenia: leukopenia

Question 11

Symptoms in Fanconi Anemia begin to show when?

Answer 11

10 YO

Question 12

Findings in iron deficiency anmeia

Answer 12

1. Target cells

2. Microcytic hypochromic anemia

Question 13

how can we differentiate between iron-deficiency and thalassemias in a microcytic anemia?

Answer 13

Mentzer Index = MCV/RBC in millions

>13 = iron deficiency anemia

<13 = B thalassemias

Question 14

Findings in thalassemia

Answer 14

1. Low Mentzer index (< 13)
2. Basophilic stippling (also in LEAD poisoning)
3. +HgF in Hgb electrophoresis

Question 15

When does lead poisoning sx occur?

Answer 15

Infancy to toddlerhood

Question 16

Findings in lead poisoning: type of anemia, smear findings, MC due to?

Answer 16

Microcytoic hypochronic

Basophilic stipping

MC = in house before 1970, PICA, contaminated soil

Question 17

X-linked recessive disorder with heinze bodies and bite cells

Answer 17

G6PD

Question 18

AD disorder with howell jolly bodies

Answer 18

Hereditary spherocytois