Peds - Hematologic Flashcards
What can early ingestion of cow’s milk cause?
prior to 9 months
micro-hemorrhage from the gut, leading to anemia
What can lead to iron deficiency anemia in toddler’s?
Reliance on whole milk at the expense of solid food.
What nail changes may be associated with anemia?
flat, brittle, or spoon-shaped nails
Laboratory findings in IRON DEFICIENCY ANEMIA
MCV - low (microcytic) MCHC - low (hypochromic) RDW - increased TIBC - increased (available slots) Serum ferritin - low (stores) Serum iron - low Reticulocyte count - low if low Fe is cause, hi if bleeding, or in thalassemia
Which anemias tend to be found in children?
MICROcytic - HYPOchromic (small cell, less color)
Iron deficiency anemia (IDA)
Thalassemia
Lead poisoning
G6PD deficiency
NORMOcytic, NORMOchromic can too
acute blood loss
early IDA
Which anemias tend to be found in adults?
MACROcytic, NORMOchromic
B12 deficiency
folate deficiency
pernicious anemia
Treatment for iron deficiency anemia
Elemental iron until HEMOGLOBIN normalizes
AND
Replace iron stores with supplementation x 4 months
IRON OVERLOAD can cause what two serious conditions?
cirrhosis
cardiomyopathy
What can giving iron to a person with Thalassemia cause?
Iron overload
they don’t have the binding sites to use the extra iron
Laboratory findings in Thalassemia that differ from IDA.
Reticulocyte count is increased
TIBC is low (no open slots, hence risk for iron overload)
Thalassemia is typically seen in what populations?
Mediterranean
Asian
Treatment for thalassemia
Refer to hematology
Genetics variations of sickle cell -
which is carrier which is symptomatic?
HOMOzygous - Hgb SS - symptomatic
HETEROzygous - Hgb AS - carrier, usually no clinical symptoms
Features of blood work findings in sickle cell? (4)
o nucleated RBCs
o reticulocytosis (10-25%)
o Howell-Jolly bodies
o WBCs elevated
Support for sickle cell crisis (5)
o hydration o oxygen o analgesics o antibiotics o transfusion
