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Hematology > Peds Heme I > Flashcards

Peds Heme I Flashcards

1
Q

What are the components of the CBC?

A

RBCs
WBCs
Platelets

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2
Q

What is the normal RR for a neonate?

A

40-60 breaths per minute

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3
Q

What is the normal range of PMNs?

A

50-75%

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4
Q

What is the normal range of lymphocytes?

A

30%

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5
Q

What is the normal range of monocytes?

A
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6
Q

What is the normal range of bands?

A
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7
Q

What is the normal range of WBCs for a newborn?

A

9-30 thousand

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8
Q

What happens to the WBC after birth?

A

Increases

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9
Q

What is the age at which the WBCs ranges are standard?

A

after 12 years

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10
Q

When does PMN count start to decrease?

A

between 1 month and 1 year

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11
Q

What is the value of ANC?

A

Takes into account actual WBCs

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12
Q

What are the three immature PMNs that you might see?

A

Myelocytes
Metamyelocytes
Band cells

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13
Q

What are bands?

A

Immature or unsegmented PMN

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14
Q

When is the percent of bands the highest?

A

Within first two days of life

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15
Q

What is the I:T ratio?

A

take the percentage number of immature cells / total percent of PMNs

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16
Q

What is the range of normal I:T?

A

Less than 0.20

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17
Q

What happens to lymphocytes as PMNs go down?

A

Go up

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18
Q

What is the normal range of Hb for neonates?

A

14-22

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19
Q

What happens to the HB dissociation curve at birth? Why?

A

shift left d/t HbF

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20
Q

True or false: Hb levels are highest just after birth

A

True

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21
Q

What is the normal Hg:HCT ratio?

A

3:1

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22
Q

How do you diagnose polycythemia in neonates?

A

HCT >65%

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23
Q

Polycythemia is based on an arterial or venous sample?

A

venous

24
Q

Why is it that capillary samples tend to run higher in terms of HCT than venous samples?

A

Capillary usually involve some squeezing of the sample area, causing an increased proportion of cells to be obtained

25
Q

What are the three major causes of newborn polycythemia?

A

Placental insufficiency secondary to preeclampsia

Endocrine abnormalities

Trisomies

26
Q

Why is polycythemia concerning in the newborn?

A

Hyperviscosity can cause a decrease in blood flow to the heart, brain, lungs, and intestines

27
Q

What percent of pts with polycythemia exhibit polycythemia?

A

50%

28
Q

What are the signs/symptoms of polycythemia in the neonate?

A

Red
Irritability
Feeding difficulties
Lethargy

29
Q

What is the treatment for asymptomatic polycythemia?

A

Observe and support

30
Q

What is the treatment for symptomatic polycythemia?

A

Exchange transfusion

31
Q

What is exchange transfusion?

A

Draw off blood and replace with saline

32
Q

After the neonatal period, the term polycythemia refers to the HGB or the HCT when it is what level?

A

2 stds above the mean

33
Q

The RBCs life span in newborns is about how long?

A

80 days

34
Q

True or false: shortly after birth, erythropoiesis ceases b/c of oxygen rich environment

A

True

35
Q

What happens to Hb as it matures?

A

Declines over 10-12 weeks

36
Q

True or false: a Hb of 9 in the term infant, or 6 in a preterm infant is normal 10-12 week postpartum

A

True

37
Q

When does Hb climb to reach normal adult levels?

A

2 yo

38
Q

What is the best lab to get for red cell indices?

A

MCV

39
Q

What is the lower limit of the MCV in children less than 10 yo?

A

70 fL + age in years

40
Q

After 6 months of age, the upper limit of MCV is calculated how?

A

84 + (0.6*age)

41
Q

True or false: retic count is separate from the CBC

A

True

42
Q

What is polychromatophilia?

A

the ability of the bone marrow to produce retic in response to RBC loss

43
Q

What is the normal range of platelets for newborns?

A

150-450 thousand

44
Q

What is the range of platelets that spontaneous bleeding is a concern?

A

5000 ish

45
Q

What is alloimmune thrombocytopenia?

A

Transfer of maternal antibody that crosses the placenta causing destruction of platelets

46
Q

True or false: alloimmune thrombocytopenia is usually a benign issue

A

True

47
Q

What is the major concern with alloimmune thrombocytopenia?

A

Intracranial bleeding

48
Q

What are the symptoms of alloimmune thrombocytopenia?

A

Limited petechia

49
Q

If severe bleeding occurs in neonates from alloimmune thrombocytopenia? Why?

A

Give mother’s platelets

Will not react with the baby’s

50
Q

When does nadir occur in alloimmune thrombocytopenia?

A

3-4 days

51
Q

What is maternal ITP?

A

Low platelets in the infant when the mother has immune thrombocytopenia, since the IgG of mother will cross placenta, and decrease the platelets

52
Q

What is the treatment for maternal ITP?

A

IVIG

53
Q

True or false: maternal ITP is usually a severe phenomenon

A

False–usually self resolved in 1-2 weeks

54
Q

What is the usual cause of thrombocytopenia in infants? Why?

A

Bacterial or viral infection

Platelet aggregation from bacterial products

55
Q

What happens to neonatal platelet count as an infection is treated?

A

Increases

Hematology (32 decks)

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