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Jason's MD3 Paeds > The Pale Child > Flashcards

Flashcards in The Pale Child Deck (22):
1

Normal Hb in newborn?

100-120

2

Oxygen delivery

DO2 = CO X HB X Sp02 X 1.31(amount of O2 ml carried by 1g of Hb

3

how to ask Diet for assessment

Cross section
Chronological: change: transition to solids, meats

4

Breast milk good source of iron?

Yes. 6 months. Then need iron fortified cereals or meats

5

How to ask about anaemia in child?

Symptoms - fatigue, lethargy, pallor, dizziness
Look for bruising in case more insidious cause
School performance
Sites of bleeding? IBS?
Family Hx

6

how can Cow's milk cause iron deficiency?

Poor source, poor bioavailability.

7

When is iron transferred across placenta?

3rd trimester.

8

When to start iron supplementation in premature baby

Not right away, increased risk of ecoli and other bacteria.
Start around 4 weeks.

9

Bloods Ix for anaemia in child

FBE
Iron Studies: be careful cause acute phase reactant
Transferrin saturation
Reticulocyte count

10

REd cell distribution (RDW), how does it look in anaemia?

Wider distribution

11

Oral supplementation in kids, what to tell parents?

give with Vit. C, stool will go black, constipation
Not on empty stomach.
Keep it safe. Overdose.
Brush teeth after. May stain.

12

Acute effects of iron overdose

Inflammation of GI mucosa and ulceration/perforation/strictures

13

How long do you take oral for?

At least a few months. 2 months.

14

How can you tell iron supplementation is working?

Within 72 hours. Reticulocyte count should come up

15

Signs of thalassemia major

Hyper trophy of maxillary bones, more bone marrow
Hepatomegaly

16

How to decide if need a blood transfusion?

1. Do they need one? Level(guideline only), symptoms
2. Factors: comorbidities
3. Decompensating
4. Progressive? Eg. Leukaemia

17

What to do after you decide they need a blood transfusion

Consent

18

After consent to blood transfusion, do what?

Group and Crossmatch
Calculate
Kg x deltaHb X 3or4 = ml. g/dL

19

How long will a bag of blood last outside of fridge?

4 hours

20

How long do you give blood over?

2-4 hours

21

What do you add if child is normovolaemic with blood transfusion?

Add diuretic

22

How long do you monitor someone on transfusion?

Every 5 minutes.
BP, HR, rash, strider, wheeze.