Ped anemia Flashcards
1
Q
physiologic response to anemia
A
- inc CO
- enhanced oxygen extraction
- shunting of blood flow to vital organs and tissues
- conc of 2,3-DPG inc within the RBC- O2 dissociation curve shifts to the right
- EPO levels inc and RBC prod in the bone marrow increases
2
Q
extravascular hemolysis- causes what?
A
(sickle cell anemia)
-splenomegaly!
3
Q
anemia- clinical features
A
- often not seen until HgB falls below 7-8
- pallor (tongue, nail beds, palms)
- sleepiness
- irritability
- dec exercise tolerance
- flow murmur!! (CO goes up)
4
Q
severe anemia- clinical features
A
- weakness
- tachypnea
- SOB on exertion
- tachycardia
- cardiac dilatation
- high output HF
5
Q
CBC with differential- lab studies
A
- WBCs
- hemoglobin
- hematocrit
- MCV
- MCH
- MCHC
- RDW (variation in size of red cells)
- platelets
- differential- diff types of WBCs
6
Q
MCV and peripheral smear
A
- microcytic (MCV low)
- normocytic (MCV normal)
- macrocytic (MCV high)
- peripheral smear- changes in RBC morphology
7
Q
after MCV, then classify anemia how?
A
- Dec RBC production- ineffective erythropoiesis; complete or relative failure of erythropoiesis
- inc destruction or loss- hemolysis, sequestration, bleeding
8
Q
how do you decide if bone marrow is working?
A
reticulocyte count!!
-if low, means an inadequate bone marrow response to anemia
9
Q
if MCV <78
A
- iron def!!!!- blood loss, dietary
- lead intoxication!!!
- chronic dz (hepcidin)
- thalassemias
- hemoglobinopathies
- sideroblastic anemias
- retic count probably low
10
Q
iron def
A
-microcytic hypochromic anemia!!
11
Q
lead intoxication
A
-has a higher RDW
12
Q
MCV normal (78-100) and retic > 3%
A
-HS
-G6PD
-autoimmune hemolytic anemia
-microangiopathic hemolytic anemias
(bone marrow is keeping up!)
13
Q
parvovirus B19- causes?
A
aplastic anemia
low reticulocyte count
14
Q
Diamond-Blackfan syndrome
A
- congenital pure red cell aplasia!!
- neonatal period
15
Q
Fanconi anemia
A
-affects all cell lines
