Flashcards in BRS- Heme Deck (114)
At what point in life is the physiologic nadir of hemoglobin concentration?
Time of HbF disappearance?
2-3 months= nadir
6-9 months= HbF disappearance
How common is anemia in kids?
20% US kiddos
80% worldwide kiddos
Reticulocyte count reflects _____.
Normal percent blood count made up of retics?
number of immature RBCs/ activity of bone marrow
2 Most common types of microcytic, hypochromic anemia in kids? 3 others?
#2: B thal
(also: lead, sideroblastic, chronic dz)
Causes of IDA in kiddos
-lack of dietary iron
-early ingestion of cows milk
-occult blood loss
2 weird key symptoms of anemia
spoon shaped nails
also paleness, fatigue etc
Labs assc with IDA:
-low ferritin (early)
-decreased transferrin saturation
-increased free erythrocyte protoporphyrin
3 causes of macrocytic anemia
Normocytic normochromic anemia with low retic counts
-red cell aplasias
Three types of red cell aplasia
When should workup to determine cause of anemia begin?
When anemia is not responsive to iron therapy.
PE finding in thalassemias
-increased size of bone in the face (chipmunk facies)
-increased size of bone in the skull (crew cut)
What populations are predisposed to a/b thal?
How many types of A thal exist?
A thal- 4
B thal- 2
(4 alleles exist for A, 2 for B)
What are the two most severe types of a thal?
-HbH disease, some Hb Barts present, which binds O2 very tightly
-Fetal Hydrops, only Hb Barts present, not compatible with life.
(BARTS BABIES BAD!)
Labs assc with B Thal
-high bili/LDH (hemolysis)
Complication assc with thalassemia treatment and how to prevent it?
-hemochromatosis due to chronic transfusion
-prevent with deferoxamine
Iron level in B thal minor
-normal to high
basic pathologic cause
iron in the mitochondria
4 causes of of acquired sideroblastic anemia
-cogactor for absorption + source
-site of absorption
-intrinsic factor, gastric parietal cells
2 weird manifestations of B12 def
-beefy red tongue
Three classes of normocytic anemia + how to distinguish them?
-hemolytic (high retics)
-aplasia (low retics, poor bone marrow effort)
-sickle cell (high retics)
Three types of aplastic anemia
-red cell aplasia
3 features assc with hereditary spherocytosis:
Test assc with hereditary spherocytosis:
-osmotic fragility studies
Condition aside from hereditary spherocytosis that is AD And assc with spectrin?