alt in hematologic function

Question 1

RBC ped differences

Answer 1

falls for first 2-3 months

-then incr until mature levels in adolescence

Question 2

WBC ped differences

Answer 2

highest at birth

-then declines until adolescence

Question 3

most common anemia

Answer 3

iron deficiency

Question 4

chronic blood loss from __ + ___ may cause iron deficiency anemia

Answer 4

• celiac

- menorrhagia

Question 5

iron deficiency

dietary risk factors

Answer 5

• infatns not eating solids after 6 mos
• infants only fed breastmilk not fortified w iron
• infants fed cows milk too early or primarily

Question 6

iron deficiency anemia

symtom

Answer 6

pallor

Question 7

iron deficiency anemia

diagnosis

Answer 7

• CSC to look for low RBC, HgB, HcT
• serum testing for iron
• screening rec during infancy

Question 8

ANEMIA

HgB<

Answer 8

11g/dL

Question 9

increase dietary iron

Answer 9

• Fe supplements start at 2-6 months depending on risk level
• educate parents about food w Fe + vit C
• cows milk restriction

Question 10

Ferrous sulfate

s/e

Answer 10

constipation + GI discomfort

-black colored stools are normal

Question 11

Ferrous sulfate

education

Answer 11

• taper off once food intake is sufficient

- do NOT give w food or antacids

Question 12

normocytic anemia

Answer 12

anemia w norm sized cells

-can be due to hemorrhage

Question 13

sickle cell disease

triggers

Answer 13

• hypoxia
• fever
• stress
• high altitudes
• vasoconstrictoin fr cold weather

Question 14

acute vaso-occlussive crisis fr sickle cell

Answer 14

• lasts 4-6 days
• severe pain to bones, joinds, + abdomen
• swollen joints, hands, + feet

Question 15

chronic vaso-occlussive crisis fr sickle cell

Answer 15

• incr risk of infections
• retinal detachment or blindness
• renal failure + enuresis
• liver cirrhosis + hepatomegaly

Question 16

sicle cell disease complications

Answer 16

1 splenic/hepatic sequestration
2 acute chest syndrome
3 aplastic crisis
4 stroke
5 sepsis
6 hyperhemolytic crisis

Question 17

splenic/hepatic sequestration

Answer 17

excessive pooling of blood esp in spleen

-reduces circulating vol> progress to hypovolemic shock

Question 18

acute chest syndrome

Answer 18

tachypnea
dyspnea
retractions
decr o2 sat
chest/back/ab pain
cough

Question 19

aplastic crisis

Answer 19

extreme anemia d/t decr RBC production

-usually fr viral infection

Question 20

sepsis fr sickle cell

Answer 20

• osteomyelitis
• septic arthritis
• meningitis

Question 21

thalassemias

Answer 21

inherited blood disorder of hgb synth

Question 22

thalassemias

s/s

Answer 22

chronic hypoxia

• headache
• irritability
• precordial + bone pain
• exercise intolerance
• anorexia
• epistaxis

Question 23

thalassemias

detection

Answer 23

usually detected in infancy or toddlerhood

-first s/s: pallor, FTT

Question 24

hemophilia A

Answer 24

deficiency in factor VIII

• males
• more common

Question 25

hemophilia B

Answer 25

deficiency of factor IX | males

Question 26

hemophilia is usually not detected until..

Answer 26

about 6 mos of age | -as they become injured fr falling over

Question 27

hemophilia | s/s

Answer 27

- hemarthrosis - headache - slurred speech - decr LOC

Question 28

hemarthrosis fr hemophilia

Answer 28

-bleeding into joint space esp knees, elbows, ankles -limited ROM due to pain + swelling >>>cause deformities over time

Question 29

hemophilia | lab findings

Answer 29

- prolonged aptt | - norm pt, fibrinogen, plt count

Question 30

hemophilia | meds

Answer 30

- DDAVP - factor VIII or IX concentrates - acetaminophen for pain

Question 31

DDAVP

Answer 31

stim release of factor VIII | -good for milk cases or before procedure that can cause bleeding

Question 32

von Willebrand disease

Answer 32

most common hereditary bleeding disorder deficient or malfunctioning vWF -easy bruising, bleeds often -ddavp prn

Question 33

DIC

Answer 33

clotting systm abormally activated >clot material is used up >bleeding + hemorrhage

Question 34

common cause of DIC

Answer 34

sepsis

Question 35

DIC | therapy

Answer 35

platelet + factor replacement

Question 36

Idiopathic Thrombocytopenic Purpura

Answer 36

autoantibodies bind to platelet

Question 37

Idiopathic Thrombocytopenic Purpura | s/s

Answer 37

- multiple ecchymoses + petechiae | - mucosal bleeding inmouth/nose

Question 38

Idiopathic Thrombocytopenic Purpura | dx

Answer 38

- decr plt count | - norm Hgb + WBC

Question 39

Idiopathic Thrombocytopenic Purpura | meds

Answer 39

- corticosteroids - IVIG - IV anti-D

Question 40

Idiopathic Thrombocytopenic Purpura | prognosis

Answer 40

20% develop a chronic disease