Flashcards in Pediatric hematology Deck (30):
MCV definition and values
expression of the average volume and size of individual erythrocytes
80 macrocytic (not for peds!)
MCHC definition and values
expression of the average hemoglobin (Hgb) concentration or proportion of each RBCs occupied by Hgb as a %, "color"
Red cell distribution width definition and abnormal indications
Red call size variation (anisocytosis). Differentiates between iron deficiency anemia, thalassemia, and anemia of chronic disease
Thalassemia- normal or slightly increased
ACD- Normal RCDW
Reticulocyte count definition and indications for what type of anemia
Number of new, young RBCs in circulation, normal is 1-2%
Index of bone marrow health and response to anemia
Anemia due to bone marrow failure, hemorrhage or hemolysis
What kind of anemia is seen in pediatric population and what conditions causes it?
MIcrocytic/hypochromic anemias caused by IDA, lead poisoning that leads to IDA, thalassemia, G6PD deficiency
What causes normocytic, normochromic anemias
ACD, acute blood loss, early IDA
What kinds of anemias are primarily for adults and what causes it?
Macrocytic/ normochromic anemia caused by vitamin b12 deficiency, folate deficiency, pernicious anemia
causes of iron deficiency anemia in the infant, toddler, and adolescent
In general, caused by decreased iron intake, increased needs, or slow GI blood loss
Infancy: inadequate intake of iron (breast fed, low iron formula)
Toddlers: whole milk at the expense of solid foods
Adolescence: inadequate iron intake, menarche
Lab findings with IDA
Low MCV (microcytic)
Increased TIBC (differentiates from thalasemia)
Management of IDA
tx underlying cause
Elemental iron 3-6mg/kg/day 1-3x daily until Hgb normalizes
Replace iron stores 2-3 mg/kg/day for 4 months
s/sx of thalassemia
some states do newborn screening
Varies from symptomatic to severe
Pale or bronze
Infancy- FTT, irritability, splenomegaly, pallor
Older child- Bony changes, splenomegaly, iron overload due to multiple transfusions
risks of iron overload
cirrhosis of the liver, cardiomyopathy
Lab findings with thamassemia
decreased MCV (microcytic)
increased reticulocyte count
Hemoglobin electropharesis, beta globin gene mapping
What is a common reticulocyte count look like for sickle cell anemia>
10-25% of immature red cells without nuclei (normal is 1-2%)
What are Howell-Jolly bodies?
cells seen in a splenic conditions (sickle cell)
What makes sickle cell diagnosis?
What does hydroxyurea do
stimulates fetal hemoglobin (Hgb F) which does not sickle
What factor is deficient in hemophilia A
What level does the CDC consider lead poisoning?
s/sx of lead poisoning
Vague/ Gi symptoms
Severe: lethargy, difficult walking, neuropathies
Burtonian lines: blueish discoloration of gingival border
What year of residence is known for lead poisoning?
What blood level of lead and class is chelation therapy recommended?
class IV 45-69
What should you observe for in lead poisoning?
IDA, hemoglobinopathies, impaired renal function, vitmain D deficiencies
A group of malignant hematological diseases in which normal bone marrow elements are replaced by abnormal, poorly differentiated lymphocytes known as blast cells
ALL- % of cases and peak age, cure rate
Acute lymphocytic leukemia- 75% of all cases, peak around 4 years old, has 95% cure rate
AML- % of cases, age range
Acute myelogenous leukemia- 20% of all leukemia, primarily in infants and older children
anemia, pale, listless, irritable chronically tired, history of repeated infections, bleeding such as epistaxis, petechia, and hematomas, lymphadenopathy and hepatosplenomegaly, bone and joint pains are a late sign
What will show up on a blood count in 85% of leukemia
thrombocytopenia and anemia
What is the hallmark trait of bone marrow for leukemia
Bone marrow will show the poorly differentiated blast cells that have been replacing the healthy bone marrow tissue