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36 Cards in this Set
- Front
- Back
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Where does hematopoiesis hapepn in the fetus?
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1st trimester: yolk sac
2nd trimester: liver 3rd trimester: marrow Hematopoietic cells migrate to the liver from the yolk sac |
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What are the two chromosomes that are reponsible for globinsynthesis?
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Chromosome 11
Chromosome 16 |
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What are the types of of hemoglobin made on chromosome 11?
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Epsilons
Gamma Delta Beta |
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What are the globins made on chromosme 16?
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Zeta
Alpha |
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What combinations of the different globin chains make up adult and fetal hemoglobins?
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What types of hemoglobin are found in babies at birth?
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50%: Hgb F
50%: Hgb A1 |
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What are the embryonic fetal hemaglobins?
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Episilon
Zeta |
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What are the normal levels for newborn hemoglobin? 2 months?
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Newborns: 17-18
2 months: 10-12 Kids are anemic when they're little: adult NL is 14-16 |
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What are the properties of the RBC membrane in newborns?
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More rigid
Less permeable to anions/cations |
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What direction is the Hgb curve shifted in infants?
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Left shift
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What enzyme is more present in kids related to iron oxidation?
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Met Hgb reductase
It converts MetHgb (Fe3+)--> Hbg (Fe2+) |
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Why shouldn't you give well water to infants?
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It's high in nitritates/nitrites
Increased MetHgb levels, which infants can't handle! |
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When does MetHgb increase in infants?
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6 months
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Why shouldn't you clamp the cord right away?
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Because you're going to cause the kid to be anemic!
There's still blood going back and forth between the placenta and the baby; it needs that Hgb. Also, don't hold the baby too high (blood goes back to the placenta) or too low (baby has too much blood). |
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What should platelet counts be in kids?
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>150,000/uL
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What are the WBC levels in kids?
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>12,000 uL; mostly neutrophils
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What kinds of WBCs are found in infants and preschool kids?
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Lymphocytosis
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What kinds of WBCs are found in school age kids?
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Neutrophils
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What are clotting factors in kids?
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Decreased rates of synthesis
Increased rates of clearance Kids can clot easily. |
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What factors are at normal levels at birth?
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V
VIII Fibrinogen VWF |
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What factor levels are decreased at birth?
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The vitamin K factors:
II, VII, IX, X Factors XI, XII, HMWK Anticoagulents: AT3, PC, PS |
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What are the coagulation lab parameters in newborns?
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PT: increased
PTT: increased Platelet count: normal Bleeding times: unreliable Factor VIII: normal |
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What kinds of hemophilia can be diagnosed at birth?
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Hemophilia A (factor VIII)
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What kind of hemophilia can't you diagnose at birth?
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Hemophilia B
Hemophilia C |
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What are the TORCH infections? What can this do to a kid?
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T: toxoplasmosiso
R: rubella C: CMV H: herpes S: syphilis You can get antibodies in the mom that will get passed over to the kid |
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What is the effect of prematurity on iron status in the newborn? Why?
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Huge!
A baby gets most of its iron stores right before birth. This can result in iron deficiency if the baby is born early. |
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What is erythroblastosis fetalis?
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When Rh+ RBCs from the fetus pass over into the maternal circulation (mom is Rh-) and results in Abs being formed.
If the mom has another kid (or to this kid) IgG crosses the placenta and attacks the kids RBCs This is more likely to happen when the mom and kid share ABO typing. |
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What is the immunoglobulin that crosses the placenta?
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IgG
It's small enough to squeak through |
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Why aren't there ABO incompatibility problems between moms and babies?
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IgM can't cross the membrane
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How does ABO incompatibility progect against erythrobastosis fetalis?
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ABO is taken care of via IgM, which is brisk.
Any fetal cells coming in that are incompatible are promptly lysed by IgM before IgG can come along and figure out the Rh status. |
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What kid typically got erythroblastosis fetalis?
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2nd
3rd 4th |
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What are the signs/symptoms of erythroblastosis fetalis?
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Jaundice
Pallor Hepato-splenomegaly Hydrops (heart failure0 |
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What are the lab findings in erythroblastosis?
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Cord Hgb < 14
Reticulocyte count: 6-30% Nucleated RBC Hypoglycemia Billirubin levels are high |
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What is hydrops?
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Generalized edema
Ascites Pleural effusion Petechaie Hepatosplenomegaly |
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What's the treatment for erythroblastosis fetalis?
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Early delivery
Intrauterine intraperitoneal transfusions of Rh- Exchange transfusion Maternal plasmapheresis |
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What medication is used to manage erythroblastosis fetalis?
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Anti-D gamma globulin (Rhogam)
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