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Pediatric Disorders Flashcards

1
Q

Normal values for hemoglobin and hematocrit _____ in the pediatric population

A

VARY with AGE

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2
Q

When is the physiologic nadir (low) for hemoglobin in children?

A

2 months of age

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3
Q

At 2 months of age, what is at a physiologic low?

A

Hemoglobin

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4
Q

Due to Anemia, what will increase in the RBC?

A

2,3-DPG

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5
Q

Due to Anemia, which way will the hemoglobin-oxygen dissociation curve shift?

A

To the RIGHT

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6
Q

Due to Anemia, why does the hemoglobin-oxygen dissociation curve shift to the right?

A

Affinity of hemoglobin for oxygen DECREASES in tissues needing oxygen

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7
Q

What cardiac effects can Anemia have on children?

A

Increased cardiac output

  • Increased heart rate
  • Flow murmur may be possible
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8
Q

If Anemia develops rapidly the symptoms will be more ____

A

Dramatic

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9
Q

If Anemia develops slowly the body will?

A

Compensate better so the symptoms will be less dramatic

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10
Q

Anemia can also be due to ____ blood loss

A

Chronic blood loss

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11
Q

If Anemia is due to intravascular RBC destruction, what will the symptoms be more associated with and what can cause this?

A

Hemoglobinuria, Hemoglobinemia

- Toxins, mechanical, autoimmune

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12
Q

If Anemia is due to extravascular RBC destruction, what will the symptoms be more associated with?

A

Jaundice, splenomegaly

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13
Q

A LOW number of reticulocytes with anemia =

A

INADEQUATE bone marrow response

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14
Q

A HIGH number of reticulocytes with anemia =

A

The problem is NOT in the bone marrow

ex. hemolysis, sequestration, blood loss

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15
Q

Iron Deficient Anemia is microcytic, hypochromic and has an increased RDW. What is it usually caused by?

A

Dietary deficiency in iron

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16
Q

With Iron Deficient Anemia, what are the levels of:

Iron, Ferritin and Transferrin

A 
Iron = LOW
Ferritin = LOW
Transferrin = HIGH
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17
Q

With a pale child that drinks a lot of cow’s milk you should suspect?

A

Iron deficient anemia

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18
Q

You should suspect iron deficient anemia in a?

A

Pale child who drinks lots of cow’s milk

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19
Q

What can the Mentzer Index do?

A

Distinguish between iron deficient anemia and beta-thalassemia trait

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20
Q

What distinguishes between iron deficient anemia and beta-thalassemia trait?

A

Mentzer Index

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21
Q

How do you calculate the Mentzer index and what are its levels?

A

MCV/RBC

  • Less than 13 = beta-thalassemia trait
  • Equal to 13 = Indeterminate
  • More than 13 = iron deficient anemia
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22
Q

How do you calculate ANC?

A

(%Neutrophils + %Bands) X WBC/100

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23
Q

What is the most common class of drugs that causes Neutropenia?

A

Chemotherapeutics

24
Q

Neutropenia ANC level

A

ANC < 1500

25
Mild Neutropenia ANC level
ANC between 1000-1500
26
Moderate Neutropenia ANC level
ANC between 500-1000
27
Severe Neutropenia ANC level
ANC < 500
28
Red cheeks followed by a diffuse, erythematous rash with anemia/neutropenia/thrombocytopenia could indicate?
Parvovirus B19 infection (Fifth Disease)
29
What is absent in DiGeorge Syndrome?
NO thymus
30
What immunodeficiency is seen with DiGeorge Syndrome and why?
T cell immunodeficiency because of an absent thymus
31
What is the #1 cause of death due to ILLNESS in the U.S for children?
Brain cancer
32
What is the #2 cause of death due to ILLNESS in the U.S for children?
ACUTE Leukemias
33
What is the #1 malignancy that affects children in the U.S?
Acute Leukemias
34
What is the #1 cause of death due to ILLNESS in the U.S for children?
Brain cancer
35
What is the #1 cause of death in the U.S for children?
Accidental injuries
36
What is the most common lymphoma in children?
B-cell NON-Hodgkin lymphoma
37
What is the most common malignancy in 15-19 year olds?
Hodgkin Lymphoma
38
Hodgkin Lymphoma is most common in what age group and associated with what 3 virus infections?
15-19 year olds - HHV-6 - EBV - Cytomegalovirus
39
What do Reed Sternberg cells look like?
- Seen with Hodgkin Lymphoma | - - Owl Eyes
40
What symptoms are often seen with Hodgkin Lymphoma?
B symptoms: 1. Fever of 39/102.2 2. Night Sweats 3. Weight loss of more than 10% body weight in 6 months
41
Any patient with unexplained and persistent lymphadenopathy and/or respiratory symptoms should get?
Chest X-ray | - Rule out a mediastinal mass
42
Trisomy 21 (Down Syndrome) is associated with what malignancies?
ALL | AML
43
2 Thrombocytopenia categories
1. Decreased platelet production | 2. Increased platelet degradation
44
Possible reasons for decreased platelet production?
Genetic disorders, nutritional deficiencies, bone marrow infiltration/failure
45
How do kids feel if they have ITP and when does it usually occur?
They feel fine | - Occurs 1-3 weeks after a viral infection
46
What are the levels of platelets and PT/PTT with ITP?
Platelets < 20K | PT/PTT = NORMAL
47
ITP involves what against platelets?
Antibodies against platelets
48
With ITP the other cell lines are usually?
Normal
49
With ITP if the other cell lines are NOT normal, what should you get?
Bone marrow aspirate
50
What is the treatment for ITP in children?
Usually self-resolves with supportive care
51
If the ITP is severe with children, what is the treatment?
Prednisone
52
What is Kasabach-Merritt phenomenon?
- Thrombocytopenia - Hypo-fibrinogenemia (low fibrinogen) * GIANT HEMANGIOMA - Intravascular coagulation
53
What is Kasabach-Merritt phenomenon?
- Thrombocytopenia - Hypofibrinogenemia (low fibrinogen) * GIANT HEMANGIOMA - Intravascular coagulation
54
What are 3 red flag signs in patients with Thrombocytopenia?
1. Pancytopenia 2. LDH 3. Renal impairment
55
What are 3 red flag signs in patients with Thrombocytopenia?
1. Pancytopenia 2. LDH 3. Renal impairment

SBL (48 decks)

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