Pediatric Anemia Flashcards
How does he define anemia?
Drop in RBCs or hemoglobin below 5th percentile of normal for age
What affect does anemia have on the hemoglobin oxygen dissociation curve?
Because 2,3 DPG increases, the curve shifts to the right and the affinity of hemoglobin for oxygen drops so the oxygen is dumped out at the tissue.
What 9 pieces of information should you get when taking a history of a kid with anemia?
Age, race, gender, meds, diet, chronic diseases, infections, travel, exposures
Family history of what 4 things can help when treating a patient with anemia?
Anemia, splenomegaly, jaundice, gall stones.
5 clinical features of anemia we could see?
Pallor, tired, irritable, decreased exercise intolerance, flow murmur
What lab value do we look at when determining whether an anemia is microcytic, normo, or macro? What lab value do we look at to know if an anemia is hypo, normo, or hyperchromic?
MCV
MCHC
What are the values for MCV that tell us micro, normo, or macro?
What are the values of MCHC that tell us hypo, normo, or hyperchromic?
Less than or equal to 2.5%
Between 2.5 and 97.5
Over 97.5
Less than or equal to 32
33-34
Greater than or equal to 35
3 main/big picture causes of anemia’s? Categories.
Decreased production, destruction of RBCs, blood loss
5 principle features of intravascular hemolysis and 3 principle features of extravascular?
Anemia, jaundice, hemoglobin in urine, hemoglobin in blood, iron in urine
Big spleen, jaundice, and anemia
What are we thinking if the reticulocyte count is higher and lower with anemia?
If its lower than the bone marrow production is the problem.
If its higher, than there is hemolysis, bleeding, sequestration.
What 4 things to remember about immune hemolytic anemia in a neonate?
Positive direct Coombs test, elevated indirect bilirubin, normocytic anemia, elevated reticulocyte count.
What infection to remember and what is its role in anemia?
Parvovirus b19
Suppresses bone marrow response to anemia, so normocytic anemia with low reticulocyte count.
What kind of anemia is diamond black fan syndrome and how do we characterize it?
Macrocytic anemia with low reticulocyte count
Congenital pure red cell aplasia resulting from increased apoptosis in erythroid precursors
What kind of anemia is fanconi anemia and what is the problem?
Microcytic anemia with low reticulocytes, platelets, and leukopenia
Most common inherited form of aplastic anemia. Precursor cells have increased susceptibility to apoptosis.
Progresses to pancytopenia
What age of little one do we see diamond black fan syndrome and fanconi anemia?
Neonate, these are congenital problems
What age do we typically see iron deficiency in with kids and what to remember about it? What kind of anemia is it?
Infant to toddlerhood
Microcytic hypochromic with an elevated RDW and peripheral smear showing target cells.
What kind of anemia is thalassemia, what will the mentzer index show, what will electrophoresis show, and what will peripheral smear show?
Microcytic low RDW
Low mentzer index
HgbF
Basophilic stippling, hemolysis, and high reticulocytes
What is the mentzer index used for and how do we interpret the results?
Used to differentiate between iron deficiency anemia and beta thalassemia.
MCV/RBC count
If greater than 13 more likely iron deficiency
If less than 13 more likely beta thalassemia
What kind of anemia is lead poisoning and what do we see on peripheral smear?
Microcytic hypochromic anemia
Basophilic stippling
4 things to remember about G6PD deficiency?
Episodic hemolysis
Favs beans can trigger
X linked recessive
Heinz bodies with bite cells
2 things to remember about hereditary Spherocytosis?
75% are autosomal dominant and Howell jolly bodies
Sickle cell is what inheritance?
Autosomal recessive
