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33 Cards in this Set
- Front
- Back
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what are the 4 common scenarios of picking up anemia?
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1. child presents for routine well visit to find low hct; chid 2. child presents with parents complianing of pale, sluggish and picky eater 3. child found to be anemic while being eval for illness, FTT or recurrent infection
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what is the definiton of anemia?
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decrease in # of RBCs or a decrease in the concentration of hgb
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what is the MCV cut off for this class?
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80
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what are the 3 ways to become anemic?
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1. ineffective production 2. increasted destruction 3. blood loss
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what are the epidemologic factors rt anemia?
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genetic, ethnicity, dietary
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what are the MCVs that warrant microcytic anemia in 6 months-2 yrs, 2-5 and 5-12?
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<70, <73, <76
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what is the equation for MCV in this class?
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70 + (2 x age in years)
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what are the differentials for microcytic anemia?
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IDA, anemia of chronic disease, thalasmia, sideroblastic anemia, lead tox
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what are the test that help distinguish lead tox from IDA?
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Ferritin and Serum Fe
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what is the tx for IDA from cows milk?
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decrease milk, 6mg/kg/day for 6 months, test retic in 5-7 days to see if working, or Hgb in 1 month, then if normalizes after 3 months can do 3mg/kg/day
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what is the teaching regarding Fe admin?
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administer with meals, liquid preps may stain teeth (rinse after), GI symps are constipation, antacids and H2 blockers interfere with absorption, takes 3 months to replenish iron stores
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what is the first heme attack of a sickle cell?
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dactylitis
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what are the test done for a sickler with venous attack?
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blood culture, urine c&s, hgb electrophoresis
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what is the pattern for sickle cell trait? Sickle C trait?
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FAS; FAC
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what is the pattern for thalaseemia?
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FAA2
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what are the lab findings for sicke cell anemia?
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increased WBC, decreased hbg, increased retic, increased plts, decreased sed rate, increased serum LDH, increased serum bili
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what are sicklers at risk for?
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developing sepsis from encapsulated organisms: strep pneumo, and H flu
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what is done for febrile sicklers
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hospitaized on IV abx
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ToF: blood cultures are required for all sicklers with fever
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TRUE
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ToF: it is necessary to stop breast feeding in physiologic and breast feeding jaundice
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FALSE
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what is the rule of 2?
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for jaundice: bili rises too early (within 24 hours of life), rises too fast (>5/day), too long (>10 days in full term or >2 weeks in preterm infant), bili is too direct (>1.5)
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what are the sxs of jaundice?
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bili > 5; lethargy, poor feeding, vomiting, poor moro refelx, high pitched cry and constipation
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when does physiologic jaundice begin?
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usually 3rd day of life and resolves by day 10
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what are the causes of non-physiologic jaundice?
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hereditary hemolytic anemia (spherocytosis), ABO incomp, G6PD, maternal illness during pregnancy, TORCH, maternal drugs, labor trauma, asphyxia, delayed cord clamp or prematurity
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what are the lab findings for physiologic jaundice?
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total bili >12 and direct <1.5
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what are the etiologies of physiologic jaundice?
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1. secondary to polycythemia, birth trauma, decreased survival of RBCs, increased enterohepatic circ 2. decreased hepatic uptake of bili 3. poor conjugation secondary to decreased gluco transferase, decrease excretion of bili
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what are the causes of excess bili production?
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ABO incompat, red cell mem defects, infections, drugs, hemoglobinopathies, DIC, pyloirc stenosis, dehydration, polycythemia
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what are the causes of abnormal bili metabolism>
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crigler-najjar syndrome, gilberts disease, dubin-johnson syndrome, rector syndrome, galactosemia, hypothryoidism, and infants with diabetic mothers
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when is breast feeding prohibited for breast milk jaundice?
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only for diagnostic purposes, bili decreases after 48 hours of cessation
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ToF: there is an increase risk of other children having breast milk jaundice after the first does
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TRUE
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what are the lab tests to workup for jaundice?
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Type and coombs (infant and mom); cbc and retic, direct and indirect bili, LFTs, thyroid, TORCH, serum glucose, septic workup
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what is the bili cut off to consider phototherapy?
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10
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at what bili is an exchange transfusion used?
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>20
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