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SBL > Pediatric Disorders > Flashcards

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
Q

Mild Neutropenia ANC level

A

ANC between 1000-1500

26
Q

Moderate Neutropenia ANC level

A

ANC between 500-1000

27
Q

Severe Neutropenia ANC level

A

ANC < 500

28
Q

Red cheeks followed by a diffuse, erythematous rash with anemia/neutropenia/thrombocytopenia could indicate?

A

Parvovirus B19 infection (Fifth Disease)

29
Q

What is absent in DiGeorge Syndrome?

A

NO thymus

30
Q

What immunodeficiency is seen with DiGeorge Syndrome and why?

A

T cell immunodeficiency because of an absent thymus

31
Q

What is the #1 cause of death due to ILLNESS in the U.S for children?

A

Brain cancer

32
Q

What is the #2 cause of death due to ILLNESS in the U.S for children?

A

ACUTE Leukemias

33
Q

What is the #1 malignancy that affects children in the U.S?

A

Acute Leukemias

34
Q

What is the #1 cause of death due to ILLNESS in the U.S for children?

A

Brain cancer

35
Q

What is the #1 cause of death in the U.S for children?

A

Accidental injuries

36
Q

What is the most common lymphoma in children?

A

B-cell NON-Hodgkin lymphoma

37
Q

What is the most common malignancy in 15-19 year olds?

A

Hodgkin Lymphoma

38
Q

Hodgkin Lymphoma is most common in what age group and associated with what 3 virus infections?

A

15-19 year olds

  • HHV-6
  • EBV
  • Cytomegalovirus
39
Q

What do Reed Sternberg cells look like?

A
  • Seen with Hodgkin Lymphoma

- - Owl Eyes

40
Q

What symptoms are often seen with Hodgkin Lymphoma?

A

B symptoms:

  1. Fever of 39/102.2
  2. Night Sweats
  3. Weight loss of more than 10% body weight in 6 months
41
Q

Any patient with unexplained and persistent lymphadenopathy and/or respiratory symptoms should get?

A

Chest X-ray

- Rule out a mediastinal mass

42
Q

Trisomy 21 (Down Syndrome) is associated with what malignancies?

A

ALL

AML

43
Q

2 Thrombocytopenia categories

A
  1. Decreased platelet production

2. Increased platelet degradation

44
Q

Possible reasons for decreased platelet production?

A

Genetic disorders, nutritional deficiencies, bone marrow infiltration/failure

45
Q

How do kids feel if they have ITP and when does it usually occur?

A

They feel fine

- Occurs 1-3 weeks after a viral infection

46
Q

What are the levels of platelets and PT/PTT with ITP?

A

Platelets < 20K

PT/PTT = NORMAL

47
Q

ITP involves what against platelets?

A

Antibodies against platelets

48
Q

With ITP the other cell lines are usually?

A

Normal

49
Q

With ITP if the other cell lines are NOT normal, what should you get?

A

Bone marrow aspirate

50
Q

What is the treatment for ITP in children?

A

Usually self-resolves with supportive care

51
Q

If the ITP is severe with children, what is the treatment?

A

Prednisone

52
Q

What is Kasabach-Merritt phenomenon?

A
  • Thrombocytopenia
  • Hypo-fibrinogenemia (low fibrinogen)
  • GIANT HEMANGIOMA
  • Intravascular coagulation
53
Q

What is Kasabach-Merritt phenomenon?

A
  • Thrombocytopenia
  • Hypofibrinogenemia (low fibrinogen)
  • GIANT HEMANGIOMA
  • Intravascular coagulation
54
Q

What are 3 red flag signs in patients with Thrombocytopenia?

A
  1. Pancytopenia
  2. LDH
  3. Renal impairment
55
Q

What are 3 red flag signs in patients with Thrombocytopenia?

A
  1. Pancytopenia
  2. LDH
  3. Renal impairment

SBL (48 decks)

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