Paeds haem Flashcards
What can be used to increase the production of fetal haemoglobin in patients with sickle cell anaemia?
Hydroxycarbamide
What is the most common cause of anaemia in infancy?
Physiologic anaemia of infancy
When is there a normal dip in haemoglobin in healthy term babies? What is the cause?
- 6-9 weeks of age
- High Hb at birth -> high oxygen delivery to tissues -> negative feedback -> decreased erythropoietin production -> decreased Hb production
What are the causes of microcytic anaemia?
TAILS:
- Thalassaemia
- Anaemia of chronic disease
- Iron deficiency anaemia
- Lead poisoning
- Sideroblastic anaemia
What are the causes of normocyctic anaemia?
3 As and 2 Hs
- Acute blood loss
- Anaemia of chronic disease
- Aplastic anaemia
- Haemolytic anaemia
- Hypothyroidism
How can macrocytic anaemia be divided? Which type if vitamin deficiency caused by?
- Megaloblastic anaemia - B12 and folate deficiency
- Normoblastic macrocytic anaemia
What 2 symptoms are specific to iron deficiency anaemia?
- Pica
- Hair loss
What does a high level of reticulocytes in the blood indicate?
That anaemia is due to haemolysis or blood loss
What is the second most common type of leukaemia in children?
Acute myeloid leukaemia
What age group does ALL peak?
Ages 2-3
Leukaemia:
1) What presentation warrants referral for immediate specialist assessment?
2) If leukaemia is suspected what needs to be completed within 48 hrs
3) What would this show?
4) What are other investigations?
- Child with unexplained petechiae or hepatomegaly
- Full blood count
- Anaemia, leukopenia, thrombocytopenia, high number of abnormal white cells
- Blood film (blast cells), bone marrow biopsy
What is ITP characterised by?
Idiopathic (spontaneous) thrombocytopenia (low platelet count) causing a purpuric rash
What is ITP caused by?
A type II hypersensitivity reaction
What age group does ITP usually present?
Children under 10
What often precedes ITP?
Viral illness
What is the typical onset of symptoms in ITP?
24-48hrs
When is treatment required in ITP? What is the treatment?
- If the patient is actively bleeding/severe thrombocytopenia (plat < 10)
- Pred, IVIG, blood transfusions, platelet transfusions
What variant of haemoglobin do patients with sickle cell have? What does it cause?
- HbS
- HbS causes rbc to be an abnormal sickle shape
What is the inheritance pattern of sickle cell anaemia?
Autosomal recessive
When is sickle cell disease tested for?
On the newborn screening heel prick test at 5 days of age
What is sickle cell crisis? Give 4 examples
An umbrella term for a spectrum of acute crises related to the condition
- Vaso-occlusive crisis
- Splenic sequestration crisis
- Aplastic crisis
- Acute chest syndrome
What causes sickle cell crisis?
Can occur spontaneously or are triggered by dehydration, infection, stress, cold weather
What is the management of sickle cells crises?
- Supportive
- Low threshold for hospital addmission
- Treat infection that may have causes crisis
- Keep warm
- IV fluids
- Analgesia
What is the inheritance pattern of thalassaemia?
Autosomal recessive
