Heme/Onc Flashcards
Definition of anemia in the newborn
< 13
Normal RBC MCV
- Newborns normal up to 110
- 6 months - 2 years = 70-90 note lower than normal in children and adults
- Older children and adults = 80-100
Definition of polycythemia
- Hct >65%
- Treatment required only >70%
Problems associated with polycythemia
- Hypoglycemia
- Thrombocytopenia
- Joint pain
- Clotting
- Stroke
- Hempotysis
- Lethargy
- Hypotonia
Risk factor for polycythemia
- IUGR
- Delayed cord clamping
- Twin-twin transfusion
- IDM
- Down Syndrome
- Chronic hypoxia
Treatment for polycythemia
Partial volume exchange transfusion
Complications of pRBC transfusion
- HYPOcalcemia
- HYPERkalemia
- Thromcobytopenia
Laboratory findings in iron deficiency anemia
- Microcytic anemia
- Low transferrin saturation
- High RDW
- Low reticulocyte count
Causes of basophilic stippling
- Beta Thalassemia Major
- Lead toxicity
Vitamin K Dependent Factors
- 2, 7, 9 and 10
- Part of intrinsic pathway of coagulation cascade
Bernard-Soulier Syndrome
- Mild thrombocytopenia
- LARGE platelets
- Prolonged bleeding time
- Platelets are LARGE like a St. BERNARD*
Glanzmann thrombasthenia
- Dysfunctional platelets
- NORMAL platelet count, PTT and INR
- Possible presentation: unexplained bleeding in patient with above normal labs*
ITP
- Often occurs after viral syndrome
- LARGE platelets (think of plts being released early, when they are larger, due to immune plt destruction)
- Tx with IVIG (preferred), steroids and possible RhoGAM (if Rh+ - to cause mild hemolysis and “distract” immune system)
- Important to RULE-OUT leukemia before treating with steroids!
Main factors in extrinsic coagulation pathway
- III and VII
What part of coagulation cascade is Factor X a part of?
Common pathway
Vitamin deficiency that results in high PT/INR
Vitamin K deficiency
Wiskott-Aldrich Syndrom
- X-linked (only occurs in males)
- Thrombocytopenia, eczema, frequent infections
- Platelets small in size and/or number
- IgM low, IgA high
- Increased risk of lymphoma in 30s
- Cure with BMT
Kasabach-Merritt Syndrome
- Large, congenital vascular tumors
- No true hemangiomas
- May result in severe CONSUMPTIVE coagulopathy
- Most common in infants
What lab abnormality is seen with vitamin K deficiency?
High PT/INR
What lab abnormality is seen with Hemophilia A or B?
High PTT
Factor deficiency in Hemophilia A
- Factor VIII deficiency
* A sounds like 8*
Factor deficiency in Hemophilia B
- Factor IX deficiency
* A sounds like 8; B comes after A and 9 comes after 8*
What maternal medications may cause bleeding in infant?
- Antibiotics
- Seizure medications
- Warfarn
vonWillebrand Disease
- Deficiency of vonWillebrand factor
- Factor VIII and platelets depend on vWF
- Elevated PTT and bleeding time
- Dx = measured factors VIII and IX (to R/O hemophilia) and vWF (to confirm that level is low)
