Pediatric Hematology [Cacas] Flashcards
T or F: Fetal hematopoietic growth factor production depends on maternal growth factor production.
FALSE!
Indipendent!
T1
What are the 3 Anatomic sites of blood production?
- MESOBLASTIC
- HEPATIC
- BONE MARROW
Time in gestation wherein blood production is mesoblastic.
Start: 3rd-4th week
End: 10th-12th week
T2
Time in gestation wherein blood production is hepatic.
Start: 5th-6th week
End: 20th-24th week
T2
Time in gestation wherein blood production is myeloid.
Start: 4th-5th month
End: Death
T2
T or F: erythropoiesis in the utero uses erythroid growth factors from the mother.
FALSE!
It uses erythroid growth factors solely from fetus
T2
Transition of EPO synthesis to fetal kidney from fetal liver translates to what kind of condition?
ANEMIA
T2
T or F: fetal RBC carry i antigen.
TRUE!
I (capital) antigen in adult RBC
T2
T or F: fetal RBC withstands the shear stresses and and fragmentation.
FALSE.
It is prone due to low na k atpase pump, phospholipid and cholesterol
T2
What co-transporter enzyme is less in fetal RBC that accounts for it being prone to shear stresses and more susceptible to fragmentation and lower life span of RBCs in the neonate compared with adult?
Na+,K+ ATPase (pump)
Also less in phospholipid and cholesterol
T2
T or F: a shift to the left in O2?dissociation curve translate that it doesn’t easily release oxygen to the tissues.
TRUE!
High affinity kasi, kapit n kapit
T2
T or F: Glucose consumption by erythrocytes of term(>37wks age of gestation) and preterm (<37wks age of gestation) infants are greater than in the cells of adults
TRUE!
T2
Enzymes defficient in fetal RBC.
- Phosphofructinase - for metabolism
- Na+,K+ ATPase
T2
Increased amount of distorted RBC I
in preterm infants translates to
infantile pyknocytosis
T2
How to compute for blood volume? (Pediatric hematology)
Weight in kg x 85 ml/kg
T3
Enumerate the Factors that influence the interpretation of the normal values:
- Gestational age of the infant (whether term or preterm)
- Conduct of labor and treatment of the umbilical vessels
- Site of sampling/extraction
T3
Percentage of blood volume that resides in placental vessels in umbilical cord.
1/4 to 1/3
T3
What is the MCV in the embryo?
> 180 fL
T3
What is the MCV in the midgestation?
≈130 fL
T3
What is the MCV in the 40 week of gestation.
110 fL
T4
T or F: Anti A and anti B function as isohemagglutinins within the first 6
months of life.
TRUE
T3
Name the condition: Small amounts of the Gower hemoglobins have been detectable in a few newborns
TRISOMY 13
T3
Name the condition: Increased levels of Hb Portland have been found in cord blood of stillborn infants with
homozygous α-thalassemia
T3
Gestation period wherein there is a gradual decline in HbF occur
3rd TRIMESTER
T3
What is the total percentage of HbF at birth?
70%
T3
Test determining the presence of fetal RBCs in the maternal circulation
Kleihauer-Betke test
HbF is resistant to denaturation by strong alkali
T4
Give the Hb composition at 24th week of gestation.
- 90% HbF
- 5 - 10% HbA
T4
Give the normal ratio of HbA to HbA2 throughout life.
30:1
T4
Identify if T or F regarding the reason why term and preterm neonate has shorter RBC lifespan:
- a rapid decline in intracellular enzyme activity
- ATP loss of membrane surface area by internalization of membrane lipids;
- decreased levels of intracellular carnitine;
- increased susceptibility of membrane lipids and proteins to peroxidation;
- increased mechanical fragility due to increased membrane deformability
All are true.
T4
Enumerate contributors to anemia of prematurity: (3)
- Shortened RBC life span
- Hemodilution from a rapid gain in weight postnatally
- Inadequate RBC production
T4
Enumerate Causes of decreased RBC production in a neonate.
- Infections (congenital or postnatally acquired)
- Drug-induced suppression of the erythroid marrow
- Rarer causes:
- —-some inborn errors of metabolism,
- —-Diamond-Blackfan anemia,
- —-congenital leukemia,
- —-Down syndrome,
- —-osteopetrosis, and
- —-transient erythroblastopenia of the newborn
- —Iron deficiency is rare in newborns, unless the mother is very severely iron deficient
Enumerate Causes of increased RBC destruction in a neonate:
- immune-mediated hemolysis (e.g., Rh, ABO, or minor blood
group incompatibility, maternal autoimmune disease) - membrane defects (e.g., spherocytosis, elliptocytosis,
pyropoikilocytosis) - enzyme defects (e.g., glucose-6-phosphate dehydrogenase
[G6PD] or protein kinase deficiency) - hemoglobinopathies (e.g., thalassemias)
- acquired disorders (e.g., bacterial sepsis, congenital infections,
disseminated intravascular coagulation [DIC], microangiopathic anemia)
T5
Enumerate PHYSIOLOGIC JAUNDICE Causative Factors:
- Delayed activity of glucuronyl transferase
- Increased bilirubin load of hepatocytes
- Decreased bilirubin clearance from plasma
T5
Give the bilirubin metabolic pathway
- PRODUCTION
- TRANSPORT IN PLASma ALBUMIN
- HEPATIC UPTAKE
- COAGULATION
- SECRETION
T5
