Flashcards in Paediatric Haematology Deck (22):
1
What sites does haemopoiesis occur throughout the paediatric lifespan?
0-2 1/2 months - yolk sac
7 weeks to 7months - liver and spleen
Birth onwards - bone marrow
LIVER AND SPLEEN CAN BE RECRUITED WITH PATHOLOGY
2
What is the name by which the liver and spleen are re-recruited during pathological circumstances?
Extra-medullary haemopoiesis
3
What are the structural/function differences in HbF vs HbA?
- large spherical red balls
- Higher O2 affinity
- Higher hematocrits (which normalises to adult levels around 3 moths)
4
At birth what is the % of Hb F in the body?
55-65%
5
What chromosome codes for the alpha chains?
Chromosome 16
6
What chromosome codes for the beta chains?
Chromosome 11
7
What are the different Hb types during Hb switching?
1st trimester
zita2 epsilon2 = Hb gower
Zita2 gamma2 = Hb Portland
Alpha2 epsilon2 = Hb Gower 2
2nd trimester
alpha2 gamma2 = HbF
Neonatal
Alpha2 beta2 = HbA
Aphla 2 delta 2 = HbA2
8
Are lymphocytes higher or lower in child vs adult? Why?
Higher - immune centre = work in progress. Exposure to lots of different things e.g. pathogens, food
9
What Ig crosses the placenta?
IgG
10
What Ig does great milk contain>
IgA, IgD, IgEm IgG, IgM
11
What type of immunity is great milk providing?
Passive immunity
12
When do babies start making antibodies?
2-3.5 months
13
When do babies start making satisfactory immune response
6-12 months
14
When do we start giving vaccinations to babies?
2 months boosts immune system
15
Fetal platelets by the 1st trimester are around the same quantity as adults. Why?
Bleeding = biggest risk to foetus. Body prioritises on platelet production
16
What are the functional differences between adult platelets vs fatal?
Fetal platelets = more response to vWf but hyporespontsive to some agonists
17
What coagulation factors are in normal quantities at birth?
Fibrinogen
V
VIII
XIII
(others normalise in 6 months)
18
What coagulation factors are bit K dependent?
II, VII, IX, X
Protein C and S
19
What are babies given to prevent haemorrhagic disease of the newborn?
Vit K injections
20
What coagulation factors are deficienct in the new born?
Factors VII, IX, X, XI, XII
Prothrombin (II)
21
How is neonatal haemostasisi different to adult?
Reduced conc of coagulation inhibitors (reduced ATIII, Heparin cofactor, protein C and S)
- Raised vWf
- reduced coagulation factors
(II, VII, IX, X, XI, XII)
- different platelet aggregation
22