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Hematology > Peds I > Flashcards

Peds I Flashcards

1
Q

What are the three characteristics of anemia?

A
  1. reduced RBCs
  2. Reduced quantity of Hb
  3. Reduced MCV
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2
Q

Is an 11.5 Hb level normal for a 6 month old?

A

Yes

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3
Q

True or false: cholecystectomy at an early age is a risk factor for anemia

A

True

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4
Q

what are the concurrent diseases that are associated with anemia?

A 
JIA
SLE
renal disorders
Malignancy
Immunodeficiency disorders
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5
Q

Why is the age of a house important in determining anemia?

A

Pb levels

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6
Q

When is screening recommended for anemia?

A

9-12 mo
kindergarten entrance
Adolescents

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7
Q

Which draws are preferred for CBCs: venous or capillary draws?

A

Venous

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8
Q

HCT is approx (__)x the Hb?

A

3x

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9
Q

When should you look at the red cell indices?

A

After anemia is confirmed

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10
Q

What are the two labs for anemia eval?

A

CBC and PBS

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11
Q

What is the most useful RBC index?

A

MCV

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12
Q

In children less than 10 yrs the lower limit of HCT is what?

A

70+age in years

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13
Q

After 6 months of age, the upper limit can be calculated by (___) until the adult limit of 96 fL.

A

84+(0.6* age in years)

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14
Q

What is MCHC?

A

Mean cell Hb concentration

Measures hydration status

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15
Q

What is the normal value of MCHC?

A

> 35 g/dL

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16
Q

RDW in Fe deficiency anemia is high, normal, or low?

A

High

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17
Q

RDW in thalassemia trait is high, normal, or low?

A

Normal

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18
Q

Why is it important to look at WBC as well as RBCs when evaluating anemia?

A

Look for bone marrow suppression

pancytopenia

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19
Q

Is there is pancytopenia, what lab should you order?

A

Bone marrow biopsy

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20
Q

Increased WBCs/low platelets may be a sign of what?

A

infection (hemolytic uremic syndrome)

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21
Q

Normal WBC/low platelets and mild anemia could be a sign of what?

A

Platelet dysfunction

idiopathic thrombocytopenic purpura

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22
Q

What does the reticulocyte count tell you?

A

The rate of RBC production

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23
Q

Is the reticulocyte count a part of the CBC?

A

No

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24
Q

What are the two ways to classify anemia?

A
  1. Size of RBCs

2. Increased destruction vs decreased production

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25
Q

What are the four microcytic, hypochromic anemia?

A

Fe deficiency
Pb toxicity
Thalassemia
sideroblastic anemia

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26
Q

What are the two macrocytic, hyperchromic anemia?

A

B12

Folate deficiency

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27
Q

What type of milk has a low amount of folate?

A

Goat’s milk

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28
Q

Normocytic with decreased retics = ?

A

Diamond black anemia

Transient erythroblastopenia of childhood

Parvovirus

29
Q

Normocytic with increased reticulocytes = ?

A

Blood loss

30
Q

What does a positive coombs test indicate?

A

Immune
ABO incompatibility
Rh incompatibility

31
Q

What is the normal for MCV for under 10 yrs?

A

(70 + age in year)

32
Q

What is the recommended amount of milk intake for toddlers?

A

16-20 ozs

33
Q

What is the effect of milk consumption on Fe stores?

A

Decreases

34
Q

What are the labs like with milk caused Fe deficiency in toddlers? (MCV, RDW, TIBC, retic)

A

MCV decreased
RDW increased
TIBC increased
Retic normal to increase

35
Q

Under what age should cow’s milk be avoided?

A

12 mo

36
Q

What is TEC?

A

Idiopathic (after viral) decreased production of RBCs in the bone marrow

37
Q

What are the labs like in TEC? (MCV, Hb, retic)

A
  • MCV normal (normocytic)
  • moderate to severely low Hb
  • Retic count decreased
38
Q

What is diamond blackfan anemia?

A

Moderate to severe anemia

Sporadic inheritance pattern of abnormal ribosomal protein synthesis

39
Q

What are the labs like in diamond blackfan anemia? (MCV, retic, HbF)

A

Retic decrease
MCV normal or increases
Hb F increased

40
Q

What is the treatment for transient erythroblastopenia of childhood (TEC)?

A

Self-limited: Supportive unless need to transfuse

41
Q

What is the Fe supplement needed for treatment of Fe deficiency in childhood?

A

6 mg/kg of Elemental Fe

42
Q

When should you stop Fe supplementation in Fe deficiency anemia?

A

Until ferritin returns to normal

43
Q

What is the treatment for diamond blackfan anemia? (3)

A

Prednisone
Transfusions
Bone marrow transplant

44
Q

What are the three crises of sickle cell disease?

A
  • Vaso-occlusive
  • Aplastic
  • Hemolytic/splenic sequestration
45
Q

What is the treatment for vaso-occlusive sickle cell disease?

A

Supportive or transfusion if need to reduce sickling

46
Q

What is the drug that is used to treat sickle cell disease? How does it work?

A

Hydroxyurea

Somehow increases HbF

47
Q

What is aplastic crises in sickle cell anemia?

A

acture drop in Hct and Hb accompanied by a fall in retics

48
Q

Aplastic crises in sickle cell pts are usually caused by what?

A

Parvovirus B19

49
Q

What is the treatment for sickle cell anemia aplastic crisis?

A

Transfusion

50
Q

What is vaso-occlusive sickle cell crises?

A

sickled cells block small vessels, causing bone and tissue infarctions

51
Q

Why do you start sickle cells pts on prophylactic PCN?

A

Encapsulated bacteria are not removed well by a compromised spleen

52
Q

Osteomyelitis in sickle cell is usually caused by what?

A

Salmonella

53
Q

early on in sickle cell disease, the sickling of cells results in what? What is the consequence of this?

A

Functional asplenia

Predisposition to infx

54
Q

What is the normal range of Hb at 2 weeks?

A

13-20

55
Q

What is the normal range of Hb at 3 months?

A

9.5-14.5

56
Q

What is the normal range of Hb at 6 months to 6 yo?

A

10.5-14

57
Q

What is the normal range of Hb at 7-12 years old?

A

11-16

58
Q

What is the mean HCT levels for 2 weeks? 3 months? 6 months-6 yo? 7-12 yrs?

A

2 weeks = 50
3 mo = 36
6mo-6yo = 37
7-12yr = 38

59
Q

What is the mean MCV for 2 weeks? 3 months? 6 months-6 yo? 7-12 yrs?

A

2 weeks = 110

6mo-6yr= 70-74
7-12yo = 76-80
60
Q

What is the normal WBC range for 2 weeks? 3 months? 6 months-6 yo? 7-12 yrs?

A

2 weeks = 5-21
3 mo = 6-18
6mo-6yo = 6-15
7-12yr = 4.5-13

61
Q

What is the PBS results and reticulocyte amounts in diamond blackfan anemia?

A

Normocytic with decreased reticulocytes

62
Q

What is the PBS results and reticulocyte amounts in transient erythroblastopenia of childhood?

A

Normocytic, decreased reticulocytes

63
Q

What is the PBS results and reticulocyte amounts in parvovirus infection?

A

Normocytic, decreased reticulocytes

64
Q

What is the PBS results and reticulocyte amounts in acute blood loss?

A

Normocytic with increased reticulocytes

65
Q

What are the PE findings in diamond blackfan anemia?

A

snub nose
Wide eyes
Flattened thenar eminence
hypertelorism

66
Q

What is the drug for Fe chelation?

A

Deferoxamine

67
Q

What is sickle cell disease aplastic crisis?

A

An acute drop in Hct and Hb, accompanied by a fall in retics, after infection with parvovirus B19

68
Q

What is the cause of hemolytic crises see in sickle cell disease?

A

unknown etiology

Hematology (32 decks)

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