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SBL Exam 2 > Pediatric Anemia - Newman > Flashcards

Pediatric Anemia - Newman Flashcards

1
Q

A reduction of Hb concentration or RBC volume below the range of values occurring in healthy persons

A

anemia

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2
Q

concentration of 2,3-DPG increases within the RBC

  • oxygen dissociation curve shifts to the RIGHT
  • affinity of Hb for O2 is reduced in tissues needing to oxygenated
A

physiologic response to anemia

  • increases cardiac output
  • enhanced oxygen extraction
  • blood flow shunts to vital organs
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3
Q

what family hx should you ask about in peds anemia pt?

A
  • anemia
  • splenomegaly
  • jaundice
  • early-age onset of gallstones
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4
Q

what clinical features would you see once anemia becomes more severe?

A
  • weakness
  • tachypnea
  • SOA
  • cardiomyopathy
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5
Q

what lab tests do you order for anemia pt?

A
  • Hb/Hct

- CBC: MCV, MCH, MCHC

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6
Q

what is MCV?

A

mean corpuscular volume

- mean value of volume of RBC’s in sample

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7
Q

what is MCHC?

A

mean corpuscular hemoglobin concentration

- Hb/Hct

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8
Q

what is MCH?

A

mean corpuscular hemoglobin

- average content (mass, weight) of Hb per RBC

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9
Q

what is RDW?

A

red cell distribution width

  • measure of variability of RBC sizes in sample
  • is a percent (if all RBC’s were exactly same size, would be 0%)
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10
Q

what is a peripheral smear?

A

provides information about RBC and WBC morphology, platelet clumping and hemolysis

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11
Q

anysocytosis

A

different SIZE

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12
Q

poikilocytosis

A

different SHAPES

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13
Q

schistocytosis

A

fragments of RBC’s

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14
Q

anemia with MCV <2.5 percentile for age,race, sex

A

microcytic

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15
Q

anemia with MCV between 2.5 and 97.5 percentile for age, race, sex

A

normocytic

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16
Q

anemia with MCV >97.5 percentile for age, race, sex

A

macrocytic

17
Q

MCHC <32 g/dL

A

hypochromic

18
Q

MCHC 33-34

A

normochromic

19
Q

MCHC >35

A

hyperchromic

20
Q

what causes decreased RBC production?

A

ineffective erythropoieses

21
Q

what causes increased destruction of RBC’s?

A
  • intravascular: mechanical injury, complement fixation, parasites, toxins
  • extravascular: macrophages in reticuloendothelial system
22
Q

low or low-normal number of reticulocytes in a pt with anemia is indicative of what?

A

inadequate bone marrow response KNOW this

23
Q

increased number of reticulocytes is normal response to what?

A

anemia (bone marrow trying to keep up)

24
Q

when do you see Howell-Jolly bodies?

A

in asplenic pt (post-spelenctomy)

25
Q

when do you see the lowest point of Hb/Hct in healthy term infants?

A
  • *2 months** KNOW this

- lowest point called the nadir

26
Q

what is the age-specific cause of anemia in neonates?

A

immune hemolytic anemia

27
Q

what lab values would see for autoimmune hemolytic anemia?

A
  • positive direct Coombs test
  • elevated indirect bilirubin
  • normocytic anemia
  • elevated reticulocyte count
28
Q

what is the most likely cause of congenital infection causing anemia in neonates?

A

parvovirus B19

29
Q

macrocytic anemia with low reticulocyte count

A

Diamond-Black syndrome

- aka congenital pure red cell aplasia, resulting from increased apoptosis in erythroid precursors

30
Q

macrocytic anemia and reticulocytopenia, thrombocytopenia, leukopenia
- most common inherited form of aplastic anemia

A

Fanconi anemia

- progresses to pancytopenia

31
Q

what is the most common cause of anemia in infancy to toddlerhood?

A

iron deficiency anemia

- pay attention to cows milk consumption (not enough iron)

32
Q

what would peripheral smear show in iron deficiency anemia?

A
  • hypochromic microcytes

- target cells

33
Q

what is the mentzer index?

A

used to differentiate iron def anemia from beta thalassemia

- MCV/RBC count

34
Q

what does a mentzer index >13 indicate?

A

iron deficiency anemia

35
Q

what does a mentzer index <13 indicate?

A

beta thalassemia

36
Q

what two deficiencies cause anemia?

A
  • G6PD (Heinz and bite cells!)

- pyruvate kinase (spur cells)

37
Q

toxicity of what would lead to microcytic, hypochromic anemia?
- peripheral smear may show basophilic stippling

A

lead poisoning

SBL Exam 2 (13 decks)

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