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Flashcards in Peds Heme I Deck (55):
1

What are the components of the CBC?

RBCs
WBCs
Platelets

2

What is the normal RR for a neonate?

40-60 breaths per minute

3

What is the normal range of PMNs?

50-75%

4

What is the normal range of lymphocytes?

30%

5

What is the normal range of monocytes?

***

6

What is the normal range of bands?

***

7

What is the normal range of WBCs for a newborn?

9-30 thousand

8

What happens to the WBC after birth?

Increases

9

What is the age at which the WBCs ranges are standard?

after 12 years

10

When does PMN count start to decrease?

between 1 month and 1 year

11

What is the value of ANC?

Takes into account actual WBCs

12

What are the three immature PMNs that you might see?

Myelocytes
Metamyelocytes
Band cells

13

What are bands?

Immature or unsegmented PMN

14

When is the percent of bands the highest?

Within first two days of life

15

What is the I:T ratio?

take the percentage number of immature cells / total percent of PMNs

16

What is the range of normal I:T?

Less than 0.20

17

What happens to lymphocytes as PMNs go down?

Go up

18

What is the normal range of Hb for neonates?

14-22

19

What happens to the HB dissociation curve at birth? Why?

shift left d/t HbF

20

True or false: Hb levels are highest just after birth

True

21

What is the normal Hg:HCT ratio?

3:1

22

How do you diagnose polycythemia in neonates?

HCT >65%

23

Polycythemia is based on an arterial or venous sample?

venous

24

Why is it that capillary samples tend to run higher in terms of HCT than venous samples?

Capillary usually involve some squeezing of the sample area, causing an increased proportion of cells to be obtained

25

What are the three major causes of newborn polycythemia?

Placental insufficiency secondary to preeclampsia

Endocrine abnormalities

Trisomies

26

Why is polycythemia concerning in the newborn?

Hyperviscosity can cause a decrease in blood flow to the heart, brain, lungs, and intestines

27

What percent of pts with polycythemia exhibit polycythemia?

50%

28

What are the signs/symptoms of polycythemia in the neonate?

Red
Irritability
Feeding difficulties
Lethargy

29

What is the treatment for asymptomatic polycythemia?

Observe and support

30

What is the treatment for symptomatic polycythemia?

Exchange transfusion

31

What is exchange transfusion?

Draw off blood and replace with saline

32

After the neonatal period, the term polycythemia refers to the HGB or the HCT when it is what level?

2 stds above the mean

33

The RBCs life span in newborns is about how long?

80 days

34

True or false: shortly after birth, erythropoiesis ceases b/c of oxygen rich environment

True

35

What happens to Hb as it matures?

Declines over 10-12 weeks

36

True or false: a Hb of 9 in the term infant, or 6 in a preterm infant is normal 10-12 week postpartum

True

37

When does Hb climb to reach normal adult levels?

2 yo

38

What is the best lab to get for red cell indices?

MCV

39

What is the lower limit of the MCV in children less than 10 yo?

70 fL + age in years

40

After 6 months of age, the upper limit of MCV is calculated how?

84 + (0.6*age)

41

True or false: retic count is separate from the CBC

True

42

What is polychromatophilia?

the ability of the bone marrow to produce retic in response to RBC loss

43

What is the normal range of platelets for newborns?

150-450 thousand

44

What is the range of platelets that spontaneous bleeding is a concern?

5000 ish

45

What is alloimmune thrombocytopenia?

Transfer of maternal antibody that crosses the placenta causing destruction of platelets

46

True or false: alloimmune thrombocytopenia is usually a benign issue

True

47

What is the major concern with alloimmune thrombocytopenia?

Intracranial bleeding

48

What are the symptoms of alloimmune thrombocytopenia?

Limited petechia

49

If severe bleeding occurs in neonates from alloimmune thrombocytopenia? Why?

Give mother's platelets

Will not react with the baby's

50

When does nadir occur in alloimmune thrombocytopenia?

3-4 days

51

What is maternal ITP?

Low platelets in the infant when the mother has immune thrombocytopenia, since the IgG of mother will cross placenta, and decrease the platelets

52

What is the treatment for maternal ITP?

IVIG

53

True or false: maternal ITP is usually a severe phenomenon

False--usually self resolved in 1-2 weeks

54

What is the usual cause of thrombocytopenia in infants? Why?

Bacterial or viral infection

Platelet aggregation from bacterial products

55

What happens to neonatal platelet count as an infection is treated?

Increases