Paediatric anaemias

Question 1

why are the red cells small in iron deficiency anaemia

Answer 1

cells keep dividing until they have enough Hb, but there is not enough Hb so keep dividing getting smaller and smaller

Question 2

iron deficiency anaemia treatment

Answer 2

• change diet if needed
• sodium feredetate 2.5mls tds

Question 3

why are red cells small in beta thalassaemia major

Answer 3

can’t make Hb as fast, so cells dividing because the Hb isn’t there in high enough quantities to stop the division

Question 4

beta thalassaemia major treatment

Answer 4

blood transfusion on a regular basis to maintain a minimum Hb

Question 5

why are we doing blood transfusions regularly for beta thalassaemia major

Answer 5

we want to maintain high Hb so that the body isn’t driven to increased erythropoiesis

strong drive for erythropoiesis in these kids which leads to - bone stuff. splenomegaly.

basically all that energy going into erythropoiesis isn’t going into growing.

Question 6

complications of longterm blood transfusion

Answer 6

iron overload - accumulation in:
- cardiac
- liver
- endocrine

infection - blood borne like HIV, hepatitis, malaria, bacterial infections

Question 7

what does the spleen do to red cells

Answer 7

takes out the done red cells

Question 8

why is parvovirus a problem with anaemia in kids

Answer 8

switches off erythropoiesis for a couple of weeks so get profoundly anaemic for a couple of weeks.

Question 9

how does splenectomy help improve Hb concentration

Answer 9

extends red cell survival

Question 10

what helps decide if a splenectomy is required

Answer 10

severity of anaemia

enlarged spleen

severe jaundice

if keep getting infections

not hitting growth milestones

Question 11

what age should a patient be before they are offered splenectomy

Answer 11

6 - because of immune function of spleen. more at risk of sepsis when young