Paediatric Haematology Flashcards
Site of haematopoeisis in children
liver
Site of haematopoeisis in adults
bone marrow
What does haematocrit take into account?
Size of RBCs and concentration of Hb
Describe WBCs in children
More lymphocytes in children
IgG crosses the placenta, IgM does not
Breast milk has all antibodies
Start producing own antibodies at 2-3 months
Vaccinations start at 2 months but require regular boosters
When do foetuses reach adult numbers of platelets?
18 weeks- important to develop early as biggest risk to foetus during birth is bleeding
Describe the responsiveness of children’s platelets to VWF
Hyperresponsive
Which clotting factors are normal at birth?
Fibrinogen, FV, FVIII, FXIII
When do clotting factors reach adult values?
By 6 months
What is haemorrhagic disease of the newborn and why does it come about?
foetal vit. K is 10% of mothers- increase risk of bleeding
Describe the concentration of coagulation inhibitors in children
Decreased 9ATIII, heparin, protein C, protein S
Describe the relative concentrations of D dimers and vWF in children
Increased
Describe the 3 most common causes of peripheral destruction of RBCs causing anaemia in childhood
Haemaglobinopathy
Peripheral destruction
Blood loss
Describe 2 autoimmune haemaglobinopathy in neonates and children
Rh incompatibility- can cross placenta
ABO incompatibility- can’t corss placenta so rarely a problem
Describe a membrane defect which can cause anaemia in children
Hereditary sperocytosis
Describe 2 enzyme defects associated with anaemia in children
G6PD deficiency
Pyruvate kinase deficiency
2 examples of how blood loss in children/foetuses can come about
Twin to twin transfusion
Fetomaternal haemorrhage
What is the most common nutritional deficiency in children; iron, B12 or folate
Iron
Give 5 causes of acquired childhood anaemia
Nutritional deficiency Bone marrow failure Bone marrow infiltration Peripheral destruction; haemolysis Blood loss
Give 3 causes of congential bleeding problems in children
Platelet problems
Clotting factor problems
Connective tissue disorders (Ehler’s danlos)
Give 6 causes of acquired bleeding problems in children
Trauma Tumour Infection Immune disorder Bone marrow fialure Drug related
Give 2 examples of infections in children that can cause acquired bleeding problems
Meningococcus
HIV
Give 2 examples of primary immune disorders in children that can cause bleeding and bruising
Immune thrombocytopenia
Thrombotic thrombocytopenic purpura
Give 2 examples of secondary immune disorders in children that can cause bleeding and bruising
SLE
ALPS-autoimmune lyphoproliferative syndrome
Mode of inheritence for autoimmune lymphoproliferative syndrome
AD
