Peds - Hematologic Flashcards Preview

NP > Peds - Hematologic > Flashcards

Flashcards in Peds - Hematologic Deck (26):
1

What can early ingestion of cow's milk cause?
(prior to 9 months)

micro-hemorrhage from the gut, leading to anemia

2

What can lead to iron deficiency anemia in toddler's?

Reliance on whole milk at the expense of solid food.

3

What nail changes may be associated with anemia?

flat, brittle, or spoon-shaped nails

4

Laboratory findings in IRON DEFICIENCY ANEMIA

MCV - low (microcytic)
MCHC - low (hypochromic)
RDW - increased
TIBC - increased (available slots)
Serum ferritin - low (stores)
Serum iron - low
Reticulocyte count - low if low Fe is cause, hi if bleeding, or in thalassemia

5

Which anemias tend to be found in children?

MICROcytic - HYPOchromic (small cell, less color)


Iron deficiency anemia (IDA)
Thalassemia
Lead poisoning
G6PD deficiency

NORMOcytic, NORMOchromic can too

acute blood loss
early IDA

6

Which anemias tend to be found in adults?

MACROcytic, NORMOchromic

B12 deficiency
folate deficiency
pernicious anemia

7

Treatment for iron deficiency anemia

Elemental iron until HEMOGLOBIN normalizes
AND
Replace iron stores with supplementation x 4 months

8

IRON OVERLOAD can cause what two serious conditions?

cirrhosis
cardiomyopathy

9

What can giving iron to a person with Thalassemia cause?

Iron overload

they don't have the binding sites to use the extra iron

10

Laboratory findings in Thalassemia that differ from IDA.

Reticulocyte count is increased
TIBC is low (no open slots, hence risk for iron overload)

11

Thalassemia is typically seen in what populations?

Mediterranean
Asian

12

Treatment for thalassemia

Refer to hematology

13

Genetics variations of sickle cell -
which is carrier which is symptomatic?

HOMOzygous - Hgb SS - symptomatic
HETEROzygous - Hgb AS - carrier, usually no clinical symptoms

14

Features of blood work findings in sickle cell? (4)

o nucleated RBCs
o reticulocytosis (10-25%)
o Howell-Jolly bodies
o WBCs elevated

15

Support for sickle cell crisis (5)

o hydration
o oxygen
o analgesics
o antibiotics
o transfusion

16

What medication can be given to stimulate fetal hemoglobin (which doesn't sickle)?

Hydroxyurea

17

What supplement is important for those with sickle cell?

folic acid

18

Which anemia can lead poisoning lead to?

iron deficiency anemia

19

Where does the body store lead?

bone marrow

20

At what point is chelation therapy used for lead poisoning?

Class IV: 45-69 mcg/dL

21

A group of malignant hematological diseases in which normal bone marrow elements are replaced by abnormal, poorly differentiated lymphocytes known as blast cells.

Leukemias

22

Is bone and joint pain an early or a late sign in leukemia?

late sign

23

What are red flags for leukemia?

Lympadenopathy and hepatosplenomegaly

especially with recent fatigue, bleeding, and frequent infection

24

Which is the most common leukemia in children?

ALL - Acute Lymphocytic Leukemia = 70%

25

Epidemiology of pediatric ALL?

peak age 4 years
white
more boys than girls

26

Acute myelogenous leukemia occurs more commonly at which ages?

Infant and older children