Peds Final Review.docx - Peds Final Review Hematology Hematopoiesis \u2013 blood cell production occurs in the marrow of almost every bone Polycythemia \u2013

Peds Final Review.docx - Peds Final Review Hematology...

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Peds Final Review Hematology Hematopoiesis – blood cell production, occurs in the marrow of almost every bone. Polycythemia – an above-average increase in the number of red cells in the blood. Thrombocytopenia – a deficiency of platelets that can lead to bleeding disorders. Anemia – defined as a reduction in the number of RBCs, the quantity of hemoglobin, and the volume of packed red blood cells to below-normal levels. Leukopenia – can be caused by immune or bone marrow disorders. Iron Deficiency Anemia Most common type of anemia and the most common nutritional deficiency in children. Can be caused secondary to blood loss, malabsorption, or poor nutritional intake. Adolescents whose diets are low in vitamins and minerals o Adolescent girls who suffer from menorrhagia (heavy menstrual bleedings) are also at risk. Infants who do not consume adequate solid foods after 6 months or age and are fed only breast milk or formula that is not fortified with iron are at risk for iron deficiency. o Neonatal iron stores have been depleted by this time and their iron needs are not being met. o If mother nutritional status during pregnancy was inadequate or infant was born prematurely or part of multiple birth Chronic blood loss o Bleeding in the neonatal period o Conditions like Crohn’s disease, celiac disease, or parasitic gastrointestinal illness Screening is recommended for all children at approximately 12 months of age o Rescreening is needed in children if risk factors are identified o Frequency of screening for anemia during adolescence should be determined on an individual basis. Boys screened at least once during peak growth spurts. Girls should be screened at least every 5 years beginning at 13 years of age. Risk assessment should be performed annually Clinical Manifestation Symptoms and severity level are directly related to the amount of iron deficiency o Infants with mild anemia may be asymptomatic. o Those with severe anemia may present with pallor, fatigue, irritability, poor feeding, tachycardia, and cardiomegaly. o Pica, or consumption of nonfood items, also a symptom of iron deficiency anemia.
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Diagnosis Made on basis of clinical presentation and lab studies. o Hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, red blood cell count, and reticulocyte count to confirm the diagnosis. Hemoglobin value less than 11 g/ dL is indicative of anemia o Children with severe anemia additional recommended testing includes serum iron, serum ferritin, total iron-binding capacity, tranferrin saturation levels and stool testing for occult blood Microscopic analysis revel as RBCs to be microcytic (small in size) and hypochromic (pale in appearance) Treatment Oral elemental iron preparations o Ferrous sulfate at a dose of 3 to 6 mg/kg/day common treatment o Can cause several side effects such as constipation and gastrointestinal discomfort. Teach family about black stools and a foul aftertaste.
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