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Peds > Anemia/lymphoma > Flashcards

Anemia/lymphoma Flashcards

1
Q

Reduction of hemoglobin conc or RBC volume below healthy

A

anemia

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2
Q
  • Incr CO
  • enhanced oxygen extraction
  • shunting of blood flow to vital organs and tissues
  • Incr 2,3-BPG w/in RBC (shifts curve to the RIGHT), affinity for oxygen decr, and transfer to tissue incr
  • EPO and RBC incr
A

Physio response to anemia

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3
Q

Kids who drink lots of cows milk are at risk for…

A

Iron def anemia

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4
Q

Anemia:

  • FH of anemia, splenomegaly, jaundice, early-age gallstones
  • Clinical features: Hgb BELOW ____will see these

Pallor (tongue, nails, palms)

Sleepiness Irritability

Decr exercise tolerance

Flow murmur (incr CO)

A

7-8 g/dL

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5
Q

MCV low=?

normal=?

High?

What does the RDW tell us?

A

MCV low=microcytic

normal=normocytic

high=macrocytic

RDW: RBC distrib (ex: incr in lead poisoning)

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6
Q

Decreased RBC production, think…

A

Ineffective erythropoeisis (low MCV)

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7
Q

Incr destruction or loss of RBCs, think…

A

Hemolysis, sequestration (spleen), bleeding

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8
Q

Low or normal reticulocytes, think…

A

Bone barrow failure (ineffective erythropoiesis)

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9
Q

Incr reticulocytes, think..

A

(Normal bone marrow!)

Ongoing RBC destruction, sequestration, bleeding

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10
Q

TQ

  • Pure red cell aplasia
  • Reticulocytes low
  • Incr MCV
  • neonatal pallor
A

Diamond-Blackfan anemia

(macrocytic anemia w/ low reticulocytes)

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11
Q

TQ

  • MCV>100
  • Macrocytic, megaloblastic anemia
  • Neuropathy, sore tongue
  • Hypersegmented neuts
A

B12 deficiency

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12
Q

TQ

  • MCV normal (78-100)
  • Retic >3%
  • bite cells
A

G6PD deficiency (enzymopathy)

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13
Q

TQ

  • MCV normal (78-100)
  • Retic >3%
A

Pyruvate kinase def (enzymopathy)

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14
Q

TQ

  • Hyperpigmentation
  • hypoplasia of thenar eminence
  • dx by 8 yo
  • cafe-au-lait spots, microsomy, LBW, eye prob

What kind of anemia?

A

Fanconi anemia

Microcytic anemia w/ reticulocytopenia, thrombocytopenia, or leukopenia

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15
Q
  • pale and fussy newborn delivered by forceps
  • Hgb at 9 g/dL (N:15-18)
  • Incr head circumference
  • Reticulocyte count and bilirubin normal
A

Cranial hemorrhage w/ forcep delivery (subgaleal bleed)

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16
Q
  • Mediterranean 12 mo yo boy
  • whole milk
  • elevated wt for length
  • Hgb=9.8
  • MCV 70 (low)
  • RDW 18 (high)
A

Microcytic anemia (prob thal)

17
Q

How do you differentiate iron def from thalassemia?

A

Mentzer index=MCV/RBC

>13=iron def anemia

<13=thalassemia

18
Q
  • incr fatigue in normal wt Philippine child
  • low grade fever
  • nonspecific MSK pain
  • pallor, pale conjunctivae
  • scattered facial petechiae
  • tachy + flow murmur
  • Hbg 7.8, MCV 90, WBC 14000, reticulocyte low
  • blasts on peripheral smear
A

Normocytic anemia petechiae=thrombocytopenia

low retic=BM LEUKEMIA

19
Q

TQ

  • constitute 97% of all childhood leukemias
  • MC types of cancer under 15 yo
A

Acute leukemias

-AML or ALL

20
Q

TQ

Child appears well and has had recent viral infx, what should be considered

A

Transient erythroblastopenia of childhood (TEC)

21
Q

TQ

  • MC malig in 15-19 yo
  • lymphoreticular system
  • Reed-sternberg cell!!!! (large cell w/ multiple/multilobulated nuclei)
  • spreads in orderly fashion
A

HL

22
Q

TQ

  • painless, nontender, firm, rubbery, cervical/supraclavicular lymphadenopathy
  • mediastinal involvement

What symptoms are seen??

A

B symptoms!!!!

  • Unexplained fever 39 deg
  • Wt loss >10% body wt 3 mo
  • Drenching night sweats

Poor prognosis if relapse w/ these symptoms

23
Q

TQ

  • most present in advanced dz
  • de novo
  • 4 subtypes: Burkitt (abd, H/N), lymphoblastic (mediastinal), diffuse large B-cell lymphoma, anaplastic large cell lymphoma
  • What immune def and genetic syndromes are associated???
A

NHL

  • SCID, Wiscott-aldrich syn
  • Ataxia-telangiectasia
24
Q

TQ

  • 4 yrs
  • White>AA
  • Male>female
  • Assoc w/ trisomy 21, fanconi, ataxia telangiectasia
  • EBV assoc
  • Wiskott aldirch
A

ALL lymphoblastic leukemias

25
Q

TQ

  • Adolescent
  • M=F, races=
  • Assoc w/ trisomy 21, fanconi, ataxia-telangiectasia, diamond-blackfan, aplastic anemia
A

AML myeloid leukemias

26
Q

TQ

MCV<78

Hypochromic microcytic w/ incr RDW

Peripheral smear shows target cells (central pallor)

PICA (eat dirt)

A

Iron deficiency anemia

27
Q

TQ

MCV<78, low RDW

Basophilic stippling

hemolysis

reticulocytosis

S/S: hemolysis, pain crises, dactylitis, aplastic crises

A

Thalassemias

Microcytic hypochromic anemia

Peds (7 decks)

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