Pediatrics 1

Question 1

Exchange transfusion in sickle cell disease

Answer 1

Stroke
Acute chest syndrome
Splenic crisis
Before high risk surgery

Question 2

Lead Poisoning Tx

Home built before 1978

Answer 2

Mild 5-44 = no tx; f/u in 1 month with repeat lead level

Moderate 45-69 = PO DMSA (succimer); if can’t tolerate PO then use IV EDTA

Severe >70 = IM dimercaprol + IV EDTA

Question 3

Use of Hydroxyurea in Sickle Cell D

Answer 3

≥3 crises/year
symptomatic anemia
life threatening complications

Question 4

Hemophilia A Tx

Answer 4

Minor bleeding = desmopressin + aminocaproic acid + tranexamic acid
Major bleeding = factor VIII replacement

Question 5

Hemophilia B Tx

Answer 5

Minor or major bleeding = factor IX replacement

Question 6

vWD Tx

Answer 6

Minor bleeding and subtype 1 = desmopressin

Major bleeding and subtypes 2/3 = plasma derived vWD containing concentrates w/ factor VIII

Question 7

Henoch schonlein purpura PLT levels vs ITP PLT levels

Answer 7

HSP PLTs = normal (HSP resolves spontaneously)

ITP PLTs = low (get peripheral smear to r/o TTP and HUS)

Question 8

ITP Tx in Children

Answer 8

Skin manifestations only = observe

Bleeding = IVIG or prednisone

Question 9

ITP Tx in Adults

Answer 9

PLTs ≥ 30,000 w/o bleeding = observe

PLTs < 30,000 OR bleeding = IVIG or prednisone (1st line)