The infant or child with pallor or anemia Flashcards Preview

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Flashcards in The infant or child with pallor or anemia Deck (15):
1

Overview of etiology

1. Iron defiency
2. Thalassemia
3. Chronic renal disease
4. Hypothyroid
5. Chronic inflammatory disease
6. Lead posisening
7. Spherocytosis
8. AI hemolysis
9. Red cell enzyme
10. Hemaglobinopathies
11. Leukemia
12. Bone marrow infiltration
Leukemia
Lymphoma
Histiocytosis
Neuroblastoma
Metabolic storage
13. Bone marrow failure
14. Sickle cell

2

Investigations

1. FBC->type, bizarre cells, blast cells
2. Ferritin
3. Zn protoporphyrin
4. Lead level
5. Haemoglobin electrophoresis
6. UEC
7. Blood and urine culture
8. Bone marrow aspirate

3

How is thalassemia diagnosed

1. Beta
Electrophoresis
++HbA2 and HbF

4

Sickle cell disease- important features

1. 1 in 4 West africans, 1 in 10 Afro-carribeans
2. Recurrent acute painful crises->infection, deH, hypoxia, acidosis
3. Splenic infarcts->pneumococcal vaccine and penicillin prophylaxis
4. Poor renal function
5. Mx of acute crises
Analgesia
ReH
Antibiotics
Warmth

5

Common cancers in childhood

1. Leukemia
2. Lymphoma
3. Wilms tumor
4. Rhabdomyosarcoma
5. Retinoblastoma
6. Brain tumors
7. Germ cell tumors
8. Neuroblastoma
9. Bone tumors

6

Overview management of childhood cancer

1. Diagnosis and referral to specialised oncology services
2. Surgery
Biopsy
Excision
Insertion of IDCVC for chemoT
3. Radiotherapy
Local
TBE for bone marrow transplant
4. ChemoT
5. Prophylactic antibiotics
6. Nutritional support
7. Pain management
8. Social, OT, physioT, school, psychology

7

Most common malignancy of childhood

1. Leukemia 30%

8

Subdivisions of ALL

1. Common
2. T cell
3. Null
4. B cell

9

Short term/long term side effects of treatment leukemia

1. Tumor lysis syndrome
2. Bone marrow suppression and febrile neutropenia
3. Immunosuppression
4. Nutrition
Mucosal ulcers
Gut inflammation
Anorexia
5. Short stature, aymmetrical growth
Radiotherapy
Irradiation of HPA->delayed puberty, hypothyroidism, cortisol deficiency, gonadal failure
6. Subfertility
7. Deafness
8. Pulmonary fibrosis
9. Cardiomyopathy
10. Risk of secondary cancers
11. Chronic ill health and poor school attendance
Poor academic performance

10

Where do most childhood brain tumors occur, management and long term

1. Brainstem
2. Cerebellum

Neurosurgical resection, chemoT and radioT
Can have growth and endocrine abnormalities

11

What is neuroblastoma and how does it normally present

1. Proliferation of neural crest cells
2. Abdominal mass, skin nodules, periorbital bruising, unwell child
3. Increase in urinary catecholamines

12

Two common bone tumors in children

1. Ewing sarcoma
2. Osteosarcoma->most common type

13

Most common sites of rhabdomyosarcoma

1. Head and neck
2. Genitourinary tract
3. 50% 5 year survival with optimal treatment

14

Most common tumor in infancy

1. Retinoblastoma

15

Even without anemia, some negative consequences of iron deficiency in children

1. Impaired weight gain
2. Reduced/abnormal appetite
3. Reduced exercise tolerance
4. Increased muscle fatiguability
5. Diminished immune response to infections

Infants required oral iron elixir for 3 months

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