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Flashcards in Anemia in childhood Deck (28)
1

anemia

decreased oxygen carrying potential to support metabolic needs as a result of

reduction in RBC number
reduction in Hb
reduction in RBC volume

2

how is Hb assayed?

direct spectrophotometry

3

how is Hct assayed?

determined by RBC count and MCV

4

MCHC greater than 35 indicates what condition?

spherocytosis

5

what are the two ways anemia is classified?

1. size of RBC
2. increased destruction vs. decreased production

6

microcytic hypochromic anemia could be due to what causes?

1. iron deficiency
2. lead toxicity
3. thalassemia

7

macrocytic hyperchromic anemia could be due to what causes?

1. B12 deficiency
2. folate deficiency

8

goat milk is low in what nutrient?

folate

9

what are differentials for normocytic anemia with decreased reticulocytes?

1. diamond blackfan
2. transient erythroblastopenia of childhood
3. parvovirus

10

what are the differentials for normocytic anemia with increased reticulocytes?

1. blood loss
2. ABO / Rh incompatibility (positive Coomb's - immune)
3. membrane defect, hemoglobinopathy, G6PD, pyruvate kinase defect (negative Coomb's - non immune)

11

what are the common causes of iron deficiency anemia in childhood?

1. excessive milk intake
2. early milk intake prior to 1 year
3. blood loss

12

what are the lab values for iron deficiency anemia in childhood?

1. MCV decreased
2. RDW increased
3. ferritin decreased
4. transferrin decreased
5. serum iron decreased
6. TIBC increased
7. reticulocytes normal to increased

13

cow milk should be avoided in children until what age?

12 months

14

how does transient erythroblastopenia of childhood present?

1. decreased production of RBCs in bone marrow
2. moderate to severe anemia
3. MCV normal
4. reticulocyte count usually decreased
5. may follow a viral illness

15

how does diamond blackfan anemia present?

1. almost always under 1 year of age
2. moderate to severe anemia
3. MCV normal or sometimes increased
4. reticulocytes decreased
5. Hb F increased
6. 25% physical findings - snub nose, wide eyes, hand/finger defects, short stature

16

what is the cause for congenital pure red cell dysplasia (diamond blackfan)?

ribosomal protein synthesis is abnormal - causes lack of progenitor cells

17

what is the treatment for TEC?

supportive only unless there is CV instability, in which case transfuse

18

what is the treatment for DBA?

prednisone, transfusions

19

what is the treatment for iron deficiency anemia?

6mg/kg/day of oral elemental iron until Hb is normal, then additional two months to replete iron stores

20

what are the three sickle cell crises?

1. vaso-occlusive
2. aplastic
3. hemolytic / splenic sequestration

21

vaso-occlusive sickle cell crisis is often precipitated by what conditions?

1. infection
2. acidosis
3. dehydration
4. hypoxia

22

what is the pathology associated with vaso-occlusive sickle cell crisis?

sickled RBCs block small vessels causing bone and tissue infarctions, splenic RBC trapping, stroke, and PAIN

23

what are the treatments for vaso-occlusive sickle cell crisis?

1. supportive
2. pain management
3. hydroxyurea

24

why does hydroxyurea help treat vaso-occlusive sickle cell crisis?

increases Hb F

25

what is often the causative agent for aplastic sickle cell crisis?

parvovirus B19

26

what is the pathology associated with aplastic sickle cell crisis?

1. slow down in RBC production
2. acute drop in Hct and Hb
3. fall in reticulocytes

27

what are the features of sickle cell hemolytic crisis?

1. acute drop in Hct and Hb
2. large rise in reticulocytes - increased destruction state

28

what is the treatment for sickle cell hemolytic crisis?

prophylactic antibiotics