Anaemia Flashcards Preview

child health diploma > Anaemia > Flashcards

Flashcards in Anaemia Deck (21)
Loading flashcards...
1
Q

Hb reference ranges vary with age t/f

A

True normal for a 2/12 old baby to have a hb=94 normal lower end of range

2
Q

Low hb need a MCV and RCC

A

MCV helps you classify the anaemia as
Micro iron def anaemia /thalassemia
Normo acute blood loss / renal disease/ spherocytosis/G6PD def
Macro b12/folate/ Down’s syndrome /hopythyroidism/ Coeliac (folate)

3
Q

Iron def anaemia is the commonest cause of. Anaemia in children t/f

A

True

4
Q

Features of iron def anaemia

A

Seen 6-36/12 of age
Cows milk excess low in iron
Low oral iron
Blood film microcytic hypochromic anaemia low sr Ferritin<10

5
Q

Falsely elevated sr ferritin seen in 3 things

A

1 liver disease
Infection
3 cancer

6
Q

Management of iron def anaemia

A

1 iron supplementation 6mg/kg/day for 3 months
2 iron rich diet
3 limit cows mild 400mls per day

Rpt the blood test 10days -2weeks to check MCV and HB and sr ferritin rising. Compliance sand responses

7
Q

Prevention of iron def anaemia

A

1 iron rich foods at 6/12 of age
2 iron supplementation in prem/ twins/ blood transfusion
3 delay intro of cows milk

8
Q

Cows milk protein intolerance

A

May be seen too early intro of cows milk
Can be seen in some BF baby
See anaemia and low albumin
Treatment is boil the cows milk

9
Q

Microcytosis in childhood

Impaired formation of globulins ( thalassemia) or impaired formation of haem ( eg iron def anaemia chronic diseases)

A

True

10
Q

Thalassemia A SE Asians
B is mediteranins
C Africans

A

True

11
Q

Features of thalassemia

A

Microcytic and hypochronic RBC LOW MCV
Excess changes for the degree of low hb / normal hb
Can see RBC changes eg target cells

12
Q

B thalassemia

A

Mediterranean
Presents 3-6 months of age
Minor hypochromic microcytic anaemia mild or none
Thal B major severe transfusion dependent for life
Ix FBC and film
HbEPG diagnostic high HbA2 levels
Ferritin if anaemia can mask the HbEPG changes
DNA prenatal testing
Treatment blood transfusion for life 4/52
Iron chelation s/c < 6years oral >6years

13
Q

Thalassemia Alpha

A

SE Asians
4 gene deletion fetal hydrops die inutero
3 gene deletion mod haemolytic anaemia ? Splenectomy
2 gene deletion micro hypo +/- low hb
1 gene deletion. Silent carrier

Diagnosis difficult 
MCV low Hb may or not be anaemia ferritin +/- low
HbEPG usually normal occas see HbH rare
Family study helpful
DNA testing prenatal
14
Q

Macrocytic anaemia

A
B12 and folate def
Hypothyroidism 
Down’s syndrome 
Liver disease
Reticulocytosis
15
Q

Causes of b12 def in child

A

1 mother Pernicous anaemia IF Ab
2 vegan
3 surgical removal of Terminal Illeuim

Folate def RARE because of food fortification Coeliac disease

16
Q

Aplastic anaemia

A

Across all the blood cell types

Occasionally just the platelets check the MCV ITP

17
Q

Causes of normocytic anaemia

A

Acute blood loss ( feto/maternal )
Renal failure
Haemolytic disorder Mb def,enzyme def, hbopathies eg SS disease
Hypersplenism

18
Q

Hereditary spherocytosis

A

Autosomal dominant
Spherocytosis seen on the blood film ( raised Retic count / mild anaemia hb70-110)
Splenomegally common
Treatment
Observe and folic acid for all
Splenectomy for some FTT/Transfusion dependent/ gallstones
Aplastic Crisis is seen in parvovirus infections only get it once
Not an indictiaton for splenectomy

19
Q

G6PD def

A

Enzyme disorder in RBC normocytic anaemia
Mediterranean /SE Asian
X linked recessive ( so mostly boys BUT occas can be seen in girls)
Most children never have problems
Can be a cause for neonatal jaundice
Acute haemolytic fava beans and moth balls ( naphthalene)
Treatment is Blood transfusion
G6PD assay can be normal in crisis

20
Q

Sickle cell disease

A

Normo cytic anaemia
Mod haemolytic anemia
Film shows RBC that are sickle shaped Africa/Lebanon/ Turkey
RBC are sickle shaped and are rigid not good at carrying o2
Spleen hypofunction ( ss damage the spread more prone to serious infections
Infections in children with SS can be LIFE THREATENING
painful crisis can be anywhere blood goes head/ abdo/ chest stroke

21
Q

Acquired haemolytic anemia

A

Autoimmune disease
Microcytic haematuria. HUS/ITP
Burns
PNH