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Physiology > Pediatric Hematology [Cacas] > Flashcards

Pediatric Hematology [Cacas] Flashcards

0
Q

T or F: Fetal hematopoietic growth factor production depends on maternal growth factor production.

A

FALSE!

Indipendent!

T1

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1
Q

What are the 3 Anatomic sites of blood production?

A
  1. MESOBLASTIC
  2. HEPATIC
  3. BONE MARROW
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2
Q

Time in gestation wherein blood production is mesoblastic.

A

Start: 3rd-4th week
End: 10th-12th week

T2

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3
Q

Time in gestation wherein blood production is hepatic.

A

Start: 5th-6th week
End: 20th-24th week

T2

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4
Q

Time in gestation wherein blood production is myeloid.

A

Start: 4th-5th month
End: Death

T2

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5
Q

T or F: erythropoiesis in the utero uses erythroid growth factors from the mother.

A

FALSE!

It uses erythroid growth factors solely from fetus

T2

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6
Q

Transition of EPO synthesis to fetal kidney from fetal liver translates to what kind of condition?

A

ANEMIA

T2

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7
Q

T or F: fetal RBC carry i antigen.

A

TRUE!

I (capital) antigen in adult RBC

T2

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8
Q

T or F: fetal RBC withstands the shear stresses and and fragmentation.

A

FALSE.

It is prone due to low na k atpase pump, phospholipid and cholesterol

T2

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9
Q

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?

A

Na+,K+ ATPase (pump)

Also less in phospholipid and cholesterol

T2

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10
Q

T or F: a shift to the left in O2?dissociation curve translate that it doesn’t easily release oxygen to the tissues.

A

TRUE!

High affinity kasi, kapit n kapit

T2

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11
Q

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

A

TRUE!

T2

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12
Q

Enzymes defficient in fetal RBC.

A
  1. Phosphofructinase - for metabolism
  2. Na+,K+ ATPase

T2

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13
Q

Increased amount of distorted RBC I

in preterm infants translates to

A

infantile pyknocytosis

T2

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14
Q

How to compute for blood volume? (Pediatric hematology)

A

Weight in kg x 85 ml/kg

T3

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15
Q

Enumerate the Factors that influence the interpretation of the normal values:

A
  1. Gestational age of the infant (whether term or preterm)
  2. Conduct of labor and treatment of the umbilical vessels
  3. Site of sampling/extraction

T3

16
Q

Percentage of blood volume that resides in placental vessels in umbilical cord.

A

1/4 to 1/3

T3

17
Q

What is the MCV in the embryo?

A

> 180 fL

T3

18
Q

What is the MCV in the midgestation?

A

≈130 fL

T3

19
Q

What is the MCV in the 40 week of gestation.

A

110 fL

T4

20
Q

T or F: Anti A and anti B function as isohemagglutinins within the first 6
months of life.

A

TRUE

T3

21
Q

Name the condition: Small amounts of the Gower hemoglobins have been detectable in a few newborns

A

TRISOMY 13

T3

22
Q

Name the condition: Increased levels of Hb Portland have been found in cord blood of stillborn infants with

A

homozygous α-thalassemia

T3

23
Q

Gestation period wherein there is a gradual decline in HbF occur

A

3rd TRIMESTER

T3

24
Q

What is the total percentage of HbF at birth?

A

70%

T3

25
Q

Test determining the presence of fetal RBCs in the maternal circulation

A

Kleihauer-Betke test

HbF is resistant to denaturation by strong alkali

T4

26
Q

Give the Hb composition at 24th week of gestation.

A
  1. 90% HbF
  2. 5 - 10% HbA

T4

27
Q

Give the normal ratio of HbA to HbA2 throughout life.

A

30:1

T4

28
Q

Identify if T or F regarding the reason why term and preterm neonate has shorter RBC lifespan:

  1. a rapid decline in intracellular enzyme activity
  2. ATP loss of membrane surface area by internalization of membrane lipids;
  3. decreased levels of intracellular carnitine;
  4. increased susceptibility of membrane lipids and proteins to peroxidation;
  5. increased mechanical fragility due to increased membrane deformability
A

All are true.

T4

29
Q

Enumerate contributors to anemia of prematurity: (3)

A
  1. Shortened RBC life span
  2. Hemodilution from a rapid gain in weight postnatally
  3. Inadequate RBC production

T4

30
Q

Enumerate Causes of decreased RBC production in a neonate.

A
  1. Infections (congenital or postnatally acquired)
  2. Drug-induced suppression of the erythroid marrow
  3. 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
31
Q

Enumerate Causes of increased RBC destruction in a neonate:

A
  1. immune-mediated hemolysis (e.g., Rh, ABO, or minor blood
    group incompatibility, maternal autoimmune disease)
  2. membrane defects (e.g., spherocytosis, elliptocytosis,
    pyropoikilocytosis)
  3. enzyme defects (e.g., glucose-6-phosphate dehydrogenase
    [G6PD] or protein kinase deficiency)
  4. hemoglobinopathies (e.g., thalassemias)
  5. acquired disorders (e.g., bacterial sepsis, congenital infections,
    disseminated intravascular coagulation [DIC], microangiopathic anemia)

T5

32
Q

Enumerate PHYSIOLOGIC JAUNDICE Causative Factors:

A
  1. Delayed activity of glucuronyl transferase
  2. Increased bilirubin load of hepatocytes
  3. Decreased bilirubin clearance from plasma

T5

33
Q

Give the bilirubin metabolic pathway

A
  1. PRODUCTION
  2. TRANSPORT IN PLASma ALBUMIN
  3. HEPATIC UPTAKE
  4. COAGULATION
  5. SECRETION

T5

Physiology (4 decks)

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