Osmosis Paeds Flashcards
What happens in acute leukaemia ? What level for diagnosis?
Blast cells don’t differentiate and build up in bone marrow -> crowds out other cells differentiating
> 20% blast cells in bone marrow
What sx do you get and why in leukaemia
Loss of RBCs -> anaemia and fatigue
Loss of platelets -> thrombocytopenia -> bleeding
Loss of neutrophils -> neutropenia -> infections
How do blast cells look on microscope?
Larger than RBCs
Immature (low cytoplasm)
There are two types of blast cell what are they? How to diffferntiate?
Myleoblasts -> RBC, monocytes, granulocytes, mega karyocytes
Lymphoblasts -> B cells, T cells
Nuclear staining -> TdT only present in lymphoblasts
-myeloperoxidase in myeloblasts (via cytoplasmic staining)
B-ALL treatment ?
Chemotherapy
Need injection into CSF and scrotum as chemo doesn’t pass blood-brain or blood-testicular barrier
2 genetic causes of B-ALL and prognosis
T(12;21) - translocation of t 12 -> 21
-good prognosis
T(9;22) (philadelphia)
-poor prognosis - seen more in adults
Surface markers in B-ALL? Which surface marker is not seen in T-ALL?
CD2-CD8, CD10
CD10
How does T-ALL usually present?
Thymic mass in Teenagers (Think T)
AML seen on blood film? Age?
Auer rods
-seen in adults
Common association with duodenal atresia?
Cause?
Downs
Failure of recanalization
Usual cause of other intestinal atresia ?
Ischemia - (Superior mesenteric)
Signs of duodenal atresia?
X-ray - Double bubble (As stomach and part of duodenum filled with amniotic fluid and become distended with pylorus in middle)
-Can be seen on USS too
Polyhydroamninos - As less fluid swallowed
Bilious vomiting in first few days of life
Treatment of duodenal atresia ?
Gastric decompression - removal of fluids from stomach though NG
IV fluids
Surgery - Duodenduodenostomy (Connecting duodenum to duodenum)
