llbgurl's version from 2015-09-30 17:24

Section 1

Question Answer
when fetal stores are depleted 9-12 months
check hemoglobin9-12 m, adolescents menstrating
lead screeningquestionnaire, routine at 1=2 yr visit
described by their size, color and shaperbcs
hypochromic, normochromiccolor of rbc
vit b12 deficencymacrocytic anemia
folate deficencymarcrocytic anemia
marcrocytic anemia treatmentcorrect with diet supplements of choice with hemotologist guidance
refer to hematologistaplastic anemias
most common anemia in childrenmicrocytic anemia
anemia of chronic dieseasemicrocytic anemia
inflammatory illneses, chronic infections, renal/liver disease, endocrine disorders, malignanat/neoplastic diseasesmicrocytic anemia
iron deficiency anemiamicrocytic anemia
thalassemiamicrocytic anemia
congenital disordermicrocytic anemia
lead posioningmicrocytic anemia
infection or cancermicrocytic anemia
hemoglobin or hematocrit greater than 2 standard deviations below normaliron deficiency anemia
due to insufficient dietary iron for expanding blood volume during rapid growthmicrocytic/hypochromic anemia
insufficient stores prior to birth, prematurity, occult GI loss, FPIES, malabsorption problemsmicrocytic/hypochromic anemia
most important part of determining cause of anemiahistory
excessive milk intake, junk food and unsual eating habits, family history, pica,mensesanemia history
pallor, fatigue, tachycardia, systolic murmur, often asymptomaticanemia
treat based on low Hgb aloneiron deficiency anemia
4-6 mg/kg/day BID or TID**Elemental iron
recheck H and H after staring iron supplementone month
iron supplement one month labs normalcontinue iron supplement 2-4 more months then stop
abnormal labs at one month s/p iron supplementCBC with indicies: MCV, MCH, RDW, serum IRON, TOTAL IRON-BINDING CAPACITY, SERUM FERRITIN CONCENTRATION, free eryhtrocyte protoporphyrin FEP, peripheral blood smear, lead level
remember theses labs when checking for anemia serum iron, total-iron binding capacity, ferritin concentration
decreased MCVmacrocytic iron deficiency anemia
less red in colorhpochromic iron defciency anemia
HIGH RDW <14% number of different looking red cellsiron deficiency anemia
low ferritin, high total iron binding capacityiron deficiency anemia
iron supplement between meals between meals for increased absorption
citrusincreases iron absorption
avoid cow's milk under 1 year of ageiron deficient anemia
use iron-fortified formula and iron fortified cerealiron deficient anemia
avoid putting around infants teethiron
Black or dark green, firmer stoolsafter stating iron therapy
cause upset stomachiron supplement
liver and other red meats, dried pinto and kidney beans, cream of wheat, dry baby cereal, dried prunes and apricots, dark green leafy vegetables, sweet potatoesfoods high in iron

Section 2

Question Answer
B-Thalassemia Majora MICROcytic anemia cause by genetic defect, hemoglobin cells are formed abnormally (hypoCHROMIC), cells unable to carry oxygen normally, shorter lifespan
hypochromichemoglobin cells are formed abnormally
B-THalassemia Majorboth parents must be carriers of the gene (recessive)
B-Thalassemia Minorif one parent is carrier of the gene the disease is generally asymptomatic and does not require treatment
A-ThalassemiaMICROcytic anemia, hereditary, varies in form from carrier, varies carrier to carrier genetic counseling -- severe
A-THalassemiasevere form can cause still birth, if baby survives it is pale, premature, edematous
Hydrops fetalisA-Thalessemia, premature, pale, edematous
A-Thalassemiamost common in mediterranean, Aisian and African decent
Listlessness, short stature, delayed pubertyThalassemia
Thalessemia lab workH&H mild decrease, MCV below normal, Hemoglobin electrophoresis decrease in alpha or beta Hgb
Hypochromic Microcytic Anemiais NOT treatable with iron, failed iron therapy for anemia think this
thalassemiacounseling, transfusion with PRBCs keep hgb 10-14, splenectomy if too large, maintain optimum growth, Iron chelation, teach s/s of anemia to parents
Thalassemia majormonthly follow up