Pediatric Hematology [Cacas]

Question 0

T or F: Fetal hematopoietic growth factor production depends on maternal growth factor production.

Answer 0

FALSE!

Indipendent!

T1

Question 1

What are the 3 Anatomic sites of blood production?

Answer 1

1. MESOBLASTIC
2. HEPATIC
3. BONE MARROW

Question 2

Time in gestation wherein blood production is mesoblastic.

Answer 2

Start: 3rd-4th week
End: 10th-12th week

T2

Question 3

Time in gestation wherein blood production is hepatic.

Answer 3

Start: 5th-6th week
End: 20th-24th week

T2

Question 4

Time in gestation wherein blood production is myeloid.

Answer 4

Start: 4th-5th month
End: Death

T2

Question 5

T or F: erythropoiesis in the utero uses erythroid growth factors from the mother.

Answer 5

FALSE!

It uses erythroid growth factors solely from fetus

T2

Question 6

Transition of EPO synthesis to fetal kidney from fetal liver translates to what kind of condition?

Answer 6

ANEMIA

T2

Question 7

T or F: fetal RBC carry i antigen.

Answer 7

TRUE!

I (capital) antigen in adult RBC

T2

Question 8

T or F: fetal RBC withstands the shear stresses and and fragmentation.

Answer 8

FALSE.

It is prone due to low na k atpase pump, phospholipid and cholesterol

T2

Question 9

What co-transporter enzyme is less in fetal RBC that accounts for it being prone to shear stresses and more susceptible to fragmentation and lower life span of RBCs in the neonate compared with adult?

Answer 9

Na+,K+ ATPase (pump)

Also less in phospholipid and cholesterol

T2

Question 10

T or F: a shift to the left in O2?dissociation curve translate that it doesn’t easily release oxygen to the tissues.

Answer 10

TRUE!

High affinity kasi, kapit n kapit

T2

Question 11

T or F: Glucose consumption by erythrocytes of term(>37wks age of gestation) and preterm (<37wks age of gestation) infants are greater than in the cells of adults

Answer 11

TRUE!

T2

Question 12

Enzymes defficient in fetal RBC.

Answer 12

1. Phosphofructinase - for metabolism
2. Na+,K+ ATPase

T2

Question 13

Increased amount of distorted RBC I

in preterm infants translates to

Answer 13

infantile pyknocytosis

T2

Question 14

How to compute for blood volume? (Pediatric hematology)

Answer 14

Weight in kg x 85 ml/kg

T3

Question 15

Enumerate the Factors that influence the interpretation of the normal values:

Answer 15

1. Gestational age of the infant (whether term or preterm)
2. Conduct of labor and treatment of the umbilical vessels
3. Site of sampling/extraction

T3

Question 16

Percentage of blood volume that resides in placental vessels in umbilical cord.

Answer 16

1/4 to 1/3

T3

Question 17

What is the MCV in the embryo?

Answer 17

> 180 fL

T3

Question 18

What is the MCV in the midgestation?

Answer 18

≈130 fL

T3

Question 19

What is the MCV in the 40 week of gestation.

Answer 19

110 fL

T4

Question 20

T or F: Anti A and anti B function as isohemagglutinins within the first 6
months of life.

Answer 20

TRUE

T3

Question 21

Name the condition: Small amounts of the Gower hemoglobins have been detectable in a few newborns

Answer 21

TRISOMY 13

T3

Question 22

Name the condition: Increased levels of Hb Portland have been found in cord blood of stillborn infants with

Answer 22

homozygous α-thalassemia

T3

Question 23

Gestation period wherein there is a gradual decline in HbF occur

Answer 23

3rd TRIMESTER

T3

Question 24

What is the total percentage of HbF at birth?

Answer 24

70% T3

Question 25

Test determining the presence of fetal RBCs in the maternal circulation

Answer 25

Kleihauer-Betke test HbF is resistant to denaturation by strong alkali T4

Question 26

Give the Hb composition at 24th week of gestation.

Answer 26

1. 90% HbF 2. 5 - 10% HbA T4

Question 27

Give the normal ratio of HbA to HbA2 throughout life.

Answer 27

30:1 T4

Question 28

Identify if T or F regarding the reason why term and preterm neonate has shorter RBC lifespan: 1. a rapid decline in intracellular enzyme activity 2. ATP loss of membrane surface area by internalization of membrane lipids; 3. decreased levels of intracellular carnitine; 4. increased susceptibility of membrane lipids and proteins to peroxidation; 5. increased mechanical fragility due to increased membrane deformability

Answer 28

All are true. T4

Question 29

Enumerate contributors to anemia of prematurity: (3)

Answer 29

1. Shortened RBC life span 2. Hemodilution from a rapid gain in weight postnatally 3. Inadequate RBC production T4

Question 30

Enumerate Causes of decreased RBC production in a neonate.

Answer 30

1. Infections (congenital or postnatally acquired) 2. Drug-induced suppression of the erythroid marrow 3. Rarer causes: - ----some inborn errors of metabolism, - ----Diamond-Blackfan anemia, - ----congenital leukemia, - ----Down syndrome, - ----osteopetrosis, and - ----transient erythroblastopenia of the newborn - ---Iron deficiency is rare in newborns, unless the mother is very severely iron deficient

Question 31

Enumerate Causes of increased RBC destruction in a neonate:

Answer 31

1. immune-mediated hemolysis (e.g., Rh, ABO, or minor blood group incompatibility, maternal autoimmune disease) 2. membrane defects (e.g., spherocytosis, elliptocytosis, pyropoikilocytosis) 3. enzyme defects (e.g., glucose-6-phosphate dehydrogenase [G6PD] or protein kinase deficiency) 4. hemoglobinopathies (e.g., thalassemias) 5. acquired disorders (e.g., bacterial sepsis, congenital infections, disseminated intravascular coagulation [DIC], microangiopathic anemia) T5

Question 32

Enumerate PHYSIOLOGIC JAUNDICE Causative Factors:

Answer 32

1. Delayed activity of glucuronyl transferase 2. Increased bilirubin load of hepatocytes 3. Decreased bilirubin clearance from plasma T5

Question 33

Give the bilirubin metabolic pathway

Answer 33

1. PRODUCTION 2. TRANSPORT IN PLASma ALBUMIN 3. HEPATIC UPTAKE 4. COAGULATION 5. SECRETION T5