Pediatric Hematology/Oncology Flashcards
How is anemia defined physiologically?
Hemoglobin level too low to meet cellular oxygen demands
What is an example of anemia despite a ‘high’ hemoglobin level?
A 2-year-old child with cyanotic congenital heart disease who has a Hgb of 14 gm/dL and Hct of 40%
What is an example of no anemia despite a ‘low’ hemoglobin level?
A 2-month-old thriving premature infant with Hgb 7.5 gm/dL
How is anemia defined practically?
Hemoglobin level at least 2 standard deviations below mean value for age, gender, and race
What factors determine hemoglobin values in normal children?
Age, gender, race, degree of sexual maturation, altitude, heredity
What is the recommended method for evaluating lead poisoning?
Venous blood lead level (BLL)
What BLL is considered abnormal and warrants intervention?
≥ 5
What are reticulocytes?
Young RBCs in circulation, still with residual RNA
How are reticulocytes characterized?
Larger than normal RBCs, lack central pallor, bluish tint
What additional screening should be done if BLL is elevated?
Screen for iron deficiency
What is the normal percentage of reticulocytes in the RBC population?
0.5-1.5%
What imaging might be considered if a patient is symptomatic for lead poisoning?
Plain abdominal x-ray
How is the absolute reticulocyte count (ARC) calculated?
% retic x RBC count/L
What should be done to manage lead poisoning?
End further exposure to lead
What is the normal range for the absolute reticulocyte count (ARC)?
25,000 – 75,000
Who else should be tested if one household member has elevated BLL?
Household members/children
What public health measure can help manage lead exposure?
Lead abatement program
What does an increased reticulocyte count indicate in the presence of anemia?
Shows bone marrow response
What nutritional elements should be ensured in the diet to manage lead poisoning?
Calcium, vitamin C, iron
What therapy is used for significantly elevated BLL?
Chelation therapy
What does anemia with a low/normal ARC suggest?
Deficient production of RBCs
What is a medical emergency in the context of lead poisoning?
Symptomatic lead intoxication
What does anemia with a high reticulocyte count indicate?
Increased erythropoietic response
What does stable anemia with a low reticulocyte count indicate?
Deficient production (reduced bone marrow response)