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HEME/LYMPH Exam 2 > Pediactric Bullshit > Flashcards

Pediactric Bullshit Flashcards

1
Q

5 day old, rash, mother from central america, UTI pregnancy complication, erythematous rash at birth on face, periorbital swelling, to trunk and diaper area, hepatosplenomegaly, WBC elevated, 52% blast forms, elevated platelets, LDH high

A

DDx - syphilis, chlamydia, herpes, neuroblastoma, letterer siwe, MPD

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2
Q

erythema toxicum neonatorum

A

rash on face

not too much worse

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3
Q

neutrophil stages

A 
promyelocyte
myelocyte
metamyelocyte
band
segmented PMN
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4
Q

herpes infection

A

can cause lots of problems so test for this in babies

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5
Q

tzanck test

A

for herpes

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6
Q

lymphocytosis in infant

A

viral - EBV - mirror cells

-or upper resp infection - cough, whoops - pertussis

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7
Q

letterer-siwe disease

A

langerhans cell histiocytosis

accumulation of dendritic cells

no known cause

peak age - 2 yo

skin rash lesions - vesicular

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8
Q

leukamoid rxn

A

> 50,000 leukocytes in blood

must distinguish from CML

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9
Q

basophilic leukocytosis

A

MPD - chronic myeloid leukemia

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10
Q

leukemic hiatus

A

majority of blasts
-not progressing to mature cells as they should

also elevated LDH - suggest rapid proliferation - neoplastic disorder

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11
Q

thrombocytosis in newborn

A 
acute inflammation
blood loss
nutrition conditions
asplenia
MPD
neuroblastoma
mother substance abuse
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12
Q

transient myelproliferative disorder

A

trisomy 21 - possible mosaicism

only distinguishing factor - resolves by 12 weeks of age**

clinically identical to acute myeloid or megakaryocytic leukemia

MUST be followed by pediatric oncology physician

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13
Q

rash of true infant leukemia

A

nodular

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14
Q

FISH probe for chromosome 21q22

A

trisomy 21

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15
Q

3yo boy pallor, bruising, intermittent fever 3 weeks, low WBC, low platelets, BM shows myeloblasts, pancytopenia

A

ALL or AML

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16
Q

aplastic anemia BM

A

nothing there

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17
Q

13yo F malaise fever 1 week, bilateral nontender cervical nodes, splenomegaly, EBV titers high, WBC 135,000, low platelets, LDH high, uric acid high, 95% WBC blasts, mediastinal widening, BM lymphoblasts - T cells (CD2/7)

A

presumptive mono dx
-not mono when see high WBC blasts and marrow

high risk ALL - rapid onset - high tumor burden - WBC > 50,000

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18
Q

5yo F, bilateral leg and wrist pain, fever 103 three weeks, MCV 77, ESR 35 (sed rate), dx rheumatoid arthritis, but gets worse, elevated LDH, BM pre-B lymphocytes

A

bone pain - cytokine from lymphoblasts and marrow expansion

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19
Q

ALL

A

most common pediatric cancer - 25%

peak 2-5yo males

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20
Q

AML

A

4% of all childhood cancers

-predisposition with chemo and radiation - in older children

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21
Q

CML

A

can happen in kids, rare

myeloproliferative disorder

22
Q

syndromes with acute leukemias

A

down syndrome
fanconi
klinefelter
shwachman diamond

23
Q

WBC > 200,000

A

microemboli in brain or lungs in children
stroke or PE

more commonly in AML

24
Q

resp distress, cough, facial edema

A

suggest SVC syncrome

-mediastinal compression in ALL

25
Q

life threatening bleeding

A

secondary to DIC

in AML

26
Q

evan syndrome

A

anemic and low platelets

27
Q

DDx of leukemia malignancies

A

neuroblastoma
retinoblastoma
rhabdomyosarcoma

28
Q

confirm Dx of leukemoa

A

BM studies
flow cytometry
cytogenics

29
Q

CSF

A

must rule out CNS leukemia

need to be done under optimal conditions to prevent traumatic tap that introduces leukemic cells to CNS

30
Q

80-90% ALL

A

cured in children

31
Q

50% AML

A

cured in children

32
Q

lower risk fx

A

age 1-9 and low to normal WBC at diagnosis

33
Q

high risk fx

A

age > 10yo, infants with high WBC and those with mature B cell leukemia

34
Q

hyperdiploidy

A

better prognosis

35
Q

t9:22

A

higher risk

36
Q

ALL therapy

A

aggressive first 6-12 months

CNS prophylactics - intrathecal chemotherapy

therapy extends 2-3 years

37
Q

AML therapy

A

intensive chem for about 1 year

bone marrow transplant if possible

38
Q

risk with Tx

A

greatest risk - infection

manage fever critical

live virus vaccines - CONTRAINDICATED**

39
Q

avascular necrosis of joints

A

with corticosteroids

40
Q

tumor lysis

A 
hyperuricemia
hyperkalemia
renal failure
fatal arrhythmia
P/Ca metabolism messed up

to tx this - diuretics and lots of fluids**

41
Q

pallor, jaundice, splenomegaly

A

hemolytic process

42
Q

cold Abs

A

IgM - require complement

43
Q

warm Abs

A

IgG - no complement

44
Q

differentiate AHA from other causes of anemia

A

direct coombs

45
Q

tx of autoimmune hemolytic anemias

A

corticosteroids

increase in Hg within few days of therapy with prednisone

RBC transfusions - if anemia serious

46
Q

donath landsteiner Ab

A

cause of hemolysis

uncommon IgG cold hemolysin after viral infection and syphilis

47
Q

tx of sickle cell

A

hydroxyurea - enhances production of HgF

48
Q

ABE

A

acute bilirubin encephalopathy

49
Q

BIND

A

bilirubin induced neuro dysfunction

kernicterus

50
Q

blueberry muffin baby

A

purpura as result of EMH

HEME/LYMPH Exam 2 (16 decks)

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