Pediatrics Hematology Oncology Flashcards
How is anemia defined physiologically?
Hemoglobin level too low to meet cellular oxygen demands.
What factors determine hemoglobin values in normal children?
Age, gender, race, degree of sexual maturation, altitude, and heredity.
What is the significance of reticulocytes in diagnosing anemia?
They help distinguish among different types of anemia by indicating bone marrow response.
Why does excessive cow’s milk intake predispose children to iron deficiency?
It contains minimal iron, poorly absorbed iron, reduces intake of other foods, and may cause GI bleeding.
What are the risk factors for lead poisoning in children?
Increased susceptibility in younger children, incomplete blood-brain barrier, higher prevalence of iron deficiency, and exposure to lead sources like old paint and dust.
What systems are affected by lead poisoning and how?
Nervous system (decreased IQ, cognitive effects, seizures, encephalopathy), heme biosynthetic pathway (anemia), renal system (renal tubular dysfunction, chronic interstitial nephritis).
What is the recommended evaluation for lead poisoning?
Venous blood lead level (BLL) testing and routine screening, with intervention for BLL ≥ 5.
What management steps are taken for lead poisoning?
End exposure, test household members, lead abatement, ensure adequate nutrition, and chelation therapy for high levels.
What is the recommended action when a venous blood lead level (BLL) is ≥ 5?
Intervention is warranted.
What additional screening is suggested if elevated BLL is detected?
Screen for iron deficiency.
What imaging technique is considered if symptomatic lead poisoning is suspected?
Plain abdominal x-ray.
What dietary recommendations are made to reduce lead absorption?
Ensure adequate intake of calcium, vitamin C, iron, and avoid fasting.
What is the efficacy of chelation therapy for lead poisoning?
Limited efficacy for significantly elevated levels.
What type of anemia is frequently seen in young children with lead poisoning?
Microcytic anemia due to concomitant iron deficiency.
What are the most common causes of microcytic hypochromic anemia during childhood?
Iron deficiency, thalassemia, anemia of inflammation.
What are the two broad categories of hemoglobin disorders?
Quantitative disorders and qualitative disorders.
What is the typical age range for diagnosis of Transient Erythroblastopenia of Childhood (TEC)?
1-4 years.
What is the primary difference in lab values between Diamond Blackfan Anemia (DBA) and TEC?
DBA shows increased MCV and elevated hemoglobin F, while TEC does not.
What is the definition of neutropenia?
Decrease in the absolute neutrophil count below accepted norms for age.
What is the calculation for Absolute Neutrophil Count (ANC)?
ANC = # total WBC * (% PMNs + % bands).
What is the infectious risk associated with severe neutropenia?
Moderate to severe.
What is neutropenia?
A decrease in the absolute neutrophil count below accepted norms for age.
How is the Absolute Neutrophil Count (ANC) calculated?
Total WBC count multiplied by the sum of the percentages of PMNs and bands.
What are the severity levels of neutropenia and their associated infectious risks?
Mild (1,000-1,500) - none, Moderate (500-1,000) - minimal, Severe (<500) - moderate to severe.
What is the most common cause of neutropenia?
Infection-associated neutropenia.
What are the categories of immune neutropenias of childhood?
Chronic benign neutropenia, alloimmune, autoimmune, drug-induced.
What is the mechanism behind chronic benign neutropenia of childhood?
Anti-neutrophil antibody.
What are the clinical features of cyclic neutropenia?
Recurrent fever, pharyngitis, aphthous ulcers, periodontal disease, cycles of 21 ± 3 days.
What is the primary treatment option for chronic ITP that has a 60-80% response rate?
Splenectomy
What are the two main types of platelet disorders?
Thrombocytopenia (quantitative) and thrombasthenia (qualitative).
What is a significant risk associated with splenectomy in ITP patients?
Post-splenectomy sepsis