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23 Cards in this Set
- Front
- Back
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anemia defined
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2 standard deviations below the mean for the normal population
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by far the biggest cause of decreased or impaired production anemia in kids
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iron deficiency
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index that measures the proportion of RBC's in the face of anemia (MCV/RBC)
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Mentzer index
>13.5: iron deficiency <11.5 thalassemia |
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lowest limit of normal for MCV in the pediatric population
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age + 70
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% of world population that is estimated to be iron deficient
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15%
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laboratory features of iron deficiency anemia (5)
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elevated free erythrocyte protoporphyrin
low serum iron and ferritin high serum TIBC low transferrin saturation |
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smear characteristics of lead poisoning and important lab finding
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normoblastic hyperplasia, ringed sideroblasts, basophilic stippling, tear drop cells
FEP level is elevated more than in iron deficiency (FEP rises because lead inhibits heme synthesis) |
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**FS on newborn hemoglobin screen**
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high risk, likely diagnosis of Hb SS or S/beta thalassemia
PCN prophylaxis should be started ASAP |
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most common hemoglobinopathy in the world
problems if inherited concurrently w/ alpha or beta thalassemia |
Hemoglobin E (beta chain mutation)
Both heterzygotes (low MCV) and homozygotes (low MCV and target cells) are asymptomatic |
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test used to test for hereditary spherocytosis
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osmotic fragility test
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treatment of sickle cell disease patients under 5
They have an increased susceptibility to what type of infection? |
penicillin prophylaxis
Encapsulated bacteria (S. Pneumoniae) |
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test used to diagnose folic acid deficiency in the pediatric population
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RBC folate (not serum folate)
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If the paitent has high RBC in the face of low hemoglobin and MCV, what should you think of ?
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Thalessemia Vs Iron def.
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What are the microcytic anemias (4)?
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Iron deficeincy anemia
Pb toxicity Thalessemias Anemia of chronic disease |
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Patient has pica (e.g. dirt, furniture, shoes, ice chips)?
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Sign of iron deficiency anemia
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Tx of iron def. anemia
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therapeutic trial of iron, tx until normal hemoglobin levels and then for 2 more months to replete iron stores. (should rise 1 g/dl hgb per month)
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Findings seen w/ alpha thalassemia trait?
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Microcytosis
barts bands (all gamma chains) on new born screen High RBC low RDW (all cells similar size) and low MCV Note: patient has 2 bad genes |
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What should you always rule out in beta thal. trait?
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Iron deficiency no matter the hx or MCV and RBC ratio
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Intravascular destruction of RBC in the presence of abnormal microcirulation, what is this called, what do you see on smear and what are dz processes where this is seen?
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Microangiopathic hemolytic anemia
Shistocytes HUS and TPP |
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X-linked disease, neonate may have hyperbilirubinemia, hemolysis can be triggered by drugs or fava beans, may provide protection against malaria, Dx
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G6PD deficiency
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inheritance of Pyruvate kinase deficiency?
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AR
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Is B12 of folic acid def. anemia more common in pediatric population?
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Folic acid
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Most common cause of folic acid def. anemia in peds?
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dieterary def. is most common and Goat milk user is most common form
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