Child with Palor Flashcards Preview

Hugh's MD3 Paediatrics > Child with Palor > Flashcards

Flashcards in Child with Palor Deck (25):
1

What's the normal Hb of a newborn?

10-12

2

What is the equation for O2 delivery?

CO x Hb x SpO2 x 1.31

3

Where does the 1.31 come from in the O2 delivery equation?

Amount of oxygen carried by 1g of Hb

4

For how long is breast milk a good source of iron?

Six months

5

What are some symptoms of anaemia

Lethargy
SOB
Fatigue
Chest pain
Poor school performance

6

What is the most common cause of iron deficiency in kids?

Poor nutrition

7

Why does a cow milk diet course iron deficiency anaemia?

Reduces appetite for other foods
The iron it contains isn't as bioavailable
Cow's milk allergy causing occult loss

8

Why do premature babies get iron deficient?

Maternal iron is transferred in the third trimester
Iatrogenic loss

9

Why don't you replace iron in preterm babies immediately?

It increases the risk of certain bacterial infections
Start at around 4 weeks

10

What must you consider when interpreting iron studies in children?

Ferritin may be falsely normal or elevated due to infection/inflammation

11

How can you clarify the results of iron studies?

Reticulocyte count

12

How do you investigation Fe def.

FBE and film
Iron studies
Reticulocyte count

13

How do you differentiate Fe def and thalassaemia?

RDW - Fe def is higher
Hb electrophoresis

14

How do you replace Fe?

Oral supplementation
Infusion (caution anaphylaxis), not used as much in kids

15

What do you advise parents about iron supplementation

Can course constipation and abdo pain
Take with vitamin C, not on an empty stomach
Don't overdose
Dark stools
Brush teeth after taking it

16

What happens in iron ingestion overdose?

Inflammation of GIT
- mucosal inflammation
- Strictures

17

How long do you take oral iron for?

At least a month - usually 2 months

18

How do you tell if someone is responding to iron in anaemia?

Increases reticulocyte count

19

How does thalassaemia major present?

Hypertrophy of maxillary bones
Hepatomegaly

20

How do you decide whether to transfuse?

Symptomatic or not
Comorbidities
Progressive or not

21

How do you decide how much blood to give?

Weight (kg) x DeltaHb (g/dL) x 3-4 = ml of blood

22

How many ml of blood in a unit?

250ml

23

What is the maximum length of time over which a transfusion should be given?

6hr
Practically 4 hours

24

What do you accompany the administration of blood with (in most cases)?

Accompany with diuretic so as not to overfill

25

What must you do when administering blood?

Check that everything matches
Monitor - every 5 minutes for first half hour