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50 Cards in this Set
- Front
- Back
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Hgb and MCV at birth, 6 mths-2 yrs,12-18 yrs
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birth 13.5-24 (Hgb); 95-121 (MCV)
6 mths-2 yrs 10.5-13.5 (Hgb); 70-86 (MCV) 12-18 yrs 12-16 (HGB); 78-102 (MCV) |
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define anemia
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reduced circulating red blood cell mass
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Pathophysiology of anemia
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- less oxygen transport
-decrease blood volume -increase cardiac output |
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Dx of anemia
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-family history
-exposure history -past medical history, including meds -physical exam -complete blood count -peripheral blood smear -platelet and white blood cell |
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Signs of anemia
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-somnolence, light-headedness, headache
-angina, dyspnea, palpitations, flow murmur -fatigue, claudication, edema -pallor- conjunctiva, palmar crease -hepatosplenomegaly -irritability -Pica: desire to eat unusual things |
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Types of microcytic anemia (MCV <80)
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-iron deficiency
-thalassemia -lead toxicity |
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Types of normocytic anemia (MCV 80-100)
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-acute blood loss
-hemolytic -anemia of chronic dz -renal dz -hemoglobinopathy |
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Types of macrocytic anemia (>100)
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-folate def
-Vit B12 def (pernious anemia) -hemolytic (anemia) -alcohol -liver dz -aplastic anemia -hypothyroidism -drug effect -myelodysplasia |
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Types of megaloblastic anemia (MCV>110)
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-folate def
-B12 def/ pernicious anemia |
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Spherocyte etiologies
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-hereditary spherocytosis
-autoimmune hemolytic anemia |
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target cell etiologies
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-liver dz
-postsplenectomy -hemoglobinopathies (Hgb, C,S) -thalassemia |
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Heinz bodies etiologies
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-oxidative medications
-chemicals -enzyme def (G6PD) |
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Howell-Jolly body etiologies
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-hemolytic anemia
-megaloblastic anemia -hyposplenism -postsplenectomy |
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Basophilic stippling etiologies
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-sideroblastic anemia
-myelodysplastic syndrome -heavy metal poisoning |
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Schistocyte etiologies
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-G6PD def
-DIC -HUS -Vasculitis |
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Acanthocyte etiologies
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-liver dz
-renal failure -splenic dz -DIC -pyruvate kinase def |
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Teardrop cells etiologies
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-myelofibrosis
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Burr cell etiologies
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-liver dz
-postsplenectomy -azotemia/uremia -gastric CA |
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What is the Schilling test
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radiolabeled B12 used to investigate B12 deficiency
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Physiologic anemia of Infancy
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-normal newborns have higher Hb until third week
-decrease to 9-11 at 8-12 wks -decline in Hb level is both more extreme and more rapid in premature infants: 7-9 by 3-6 wks |
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Coombs test
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-Direct- detects auto IgG bound RBCs (autoimmune hemolysis)
-indirect- detects unbound autoantibodies to RBCs |
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Define Transient erythroblastopenia of childhood
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transient failure of the bone marrow to produce RBCs usually at 18-26 mths; may occur at < 6 mths and upt o 10 yrs
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Etiology of Transient erythroblastopenia of childhood
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linked to parvovirus B19
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signs of Transient erythroblastopenia of childhood
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gradual pallor and fatigue; appearance better than expected for Hgb level
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Differential Dx Transient erythroblastopenia of childhood
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-diamond-Blackfan anemia
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Tx for Transient erythroblastopenia of childhood
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-supportive until RBC production returns
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Dx of Transient erythroblastopenia of childhood
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-CBC:
-reticulocyte count |
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Etiology of Iron Deficiency anemia
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-inadequate intake (whole milk has no iron)
-loss of iron -bleeding -rapid growth spurts (early infancy & adolescence) -prematurity (decrease iron stores) -chronic dz (JRA, cystic fibrosis) |
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Epidemiology of Iron Deficiency anemia
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-most common anemia in children
-especially 6 mths to 3 yrs old -rare in infants under 6 mths |
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Signs of Iron Deficiency anemia
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-cheilosis /angular stomatitis, glossitis
-koilonychia (spoon nails) -esophageal webs -blue sclera -splenomegaly |
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Tx for Iron Deficiency anemia
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-ferrous sulfate for at least 8 wks
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Why doesn't normal or high ferritin not exclude iron deficiency during an acute infection
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ferritin is an acute phase reactant
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Dx of Iron Deficiency anemia
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-decrease serum ferritin (<10)
-decrease serum iron -increase iron-binding capacity -low reticulocyte count -increase platelet count (>600,000) -hypercellular marrow w/ erythroid hyperplasia -decrease stainable iron |
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Etiology of Lead poisoning
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-environment
-lead containing paint |
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Pathophysiology of Lead poisoninng
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-irreversible binding w/ sulfhydryl group of proteins
-inhibits enzymes involved in heme production -impairs iron utilization |
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signs of lead poisoning
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- acute encephalopathy
-lead lines-thick transverse radiodense lines in the metaphyses of growing bones on radiographs |
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Dx of lead poisoning
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-microcytic hypochromic anemia, basophilic stippling
-increase serum lead and free erythrocyte protoporphyrin level -increase urine coproporphyrin |
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What does chronic lead poisoning cause to occur
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it interferes w/ iron utilization and Hb synthesis
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When should lead screening occur
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-10-14 mths and 2 yrs of age
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Tx for lead poisoning
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-dimercaprol
-EDTA |
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What is the most common cause of lead poisoning
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lead paint
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define folate deficiency
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megaloblastic anemia
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Etiology of folate deficiency
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-deficienct intake or absorption
-pregnancy (increase requirement) -very low birth wt infants -drugs (phenytoin, methotrexate) -vitamin C deficiency |
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Epidemiology of folate deficiency
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peak age 4-7 mths
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signs of folate deficiency
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-features of anemia
-failure to gain wt -chronic diarrhea |
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Dx of folate deficiency
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-macrocytic anemia, thrombocytopenia, neutropenia (hypersegmented Neutrophils)
- low reticulocyte ct -Increase LDH -bone marrow hypercellular and megaloblastic changes -serum and RBC folate levels |
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What is the best indicator of chronic folate deficiency
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RBC folate
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Tx for folate deficiency
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- parenteral folic acid only after confirmation
-folic acid is contraindicated in vitamin B12 deficiency, bc it will mask anemia, yet B12 def neurologic symptoms will progress |
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Define vitamin B12 deficiency
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megaloblastic anemia
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Etiology of vitamin B12 deficiency
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-inadequate intake (strict vegetarians)
-pernicious anemia -surgery of stomach or terminal ileum |
