N4431 UTA Pediatric Exam 3 Questions With
Complete Solutions
Anemia
RBC & Hgb lower than normal
Causes of anemia:
1) Į production or loss & destruction of RBCS
related to lack of dietary intake of nutrients needed
to produce cells
2) Alterations in cell structure
3) Malfunctioning tissue
4) Toxin exposure (lead)
5) Adverse reaction to med (aplastic anemia- not
making RBCS)
Iron
Fetus: receives iron through placenta from mother
Preterm infant: misses final wks/mo of
transplacental iron transfer so ↑ risk for iron
deficiency anemia
,Term infant: physiologic anemia occurs between
2-6 mo due to rapid growth and maternal iron
stores depletion between 4 - 6 mo
Iron intake: critical for appropriate development
of hemoglobin & RBCS; iron fortified cereal, breast
milk might need iron supplement
Adolescents: rapid growth leads to ↑ risk for
anemia, must ↑ iron intake (and starting period)
Iron Deficiency Anemia
Causes: Not enough iron to produce Hgb;
decreasing maternal stores & răpid growth times
(infants & adolescents)
As Hgb levels oxygen carrying capacity of blood
resulting in weakness & fatigue; also associated
with delayed growth, cognitive dělays, & behavior
changes
Assessment: Health history: irritability, HA,
dizziness, weakness, SOB, pallor, dietary intake of
iron, health issues
Risk factors: gestational diabetes, prematurity,
maternal anemia, low iron formula, breastfed-no
iron supplements, low SES, antacids
Exam: lethargy, fatigue; inspect skin for pallor,
spooning of nails, pulse oximeter, HR - tachycardia,
murmur, splenomegaly
, Treatment: OTC - iron supplements Severe: may
need transfusion
Sickle Cell Disease (SCD)
• abnormal Hgb gene
• sickle shaped RBC's
• autosomal recessive disorder
• ethnically linked (African, Mediterranean,
Hispanic, Middle Eastern, Asian)
• HgB is protectant for the first 4-6 months of life
• occlusion and hemolysis
• premature RBC death (low RBC counts, hemolytic
anemia)
Sickle Cell Crisis
• triggered by hypoxia, acidosis, dehydration,
fever, and hypothermia
vasoocclusive : severe pain from ischemia
and dactylitis (swelling of fingers or toes)
Splenic Sequestration : blood gets trapped in
the spleen
Silent Cerebral Infarct : neuro assessment,
stroke or silent cerebral infarct
Acute Chest Syndrome : pulmonary vessel
occlusion; mimics pneumonia but infarcts and not
infiltrations
Sickle Cell Treatment
Complete Solutions
Anemia
RBC & Hgb lower than normal
Causes of anemia:
1) Į production or loss & destruction of RBCS
related to lack of dietary intake of nutrients needed
to produce cells
2) Alterations in cell structure
3) Malfunctioning tissue
4) Toxin exposure (lead)
5) Adverse reaction to med (aplastic anemia- not
making RBCS)
Iron
Fetus: receives iron through placenta from mother
Preterm infant: misses final wks/mo of
transplacental iron transfer so ↑ risk for iron
deficiency anemia
,Term infant: physiologic anemia occurs between
2-6 mo due to rapid growth and maternal iron
stores depletion between 4 - 6 mo
Iron intake: critical for appropriate development
of hemoglobin & RBCS; iron fortified cereal, breast
milk might need iron supplement
Adolescents: rapid growth leads to ↑ risk for
anemia, must ↑ iron intake (and starting period)
Iron Deficiency Anemia
Causes: Not enough iron to produce Hgb;
decreasing maternal stores & răpid growth times
(infants & adolescents)
As Hgb levels oxygen carrying capacity of blood
resulting in weakness & fatigue; also associated
with delayed growth, cognitive dělays, & behavior
changes
Assessment: Health history: irritability, HA,
dizziness, weakness, SOB, pallor, dietary intake of
iron, health issues
Risk factors: gestational diabetes, prematurity,
maternal anemia, low iron formula, breastfed-no
iron supplements, low SES, antacids
Exam: lethargy, fatigue; inspect skin for pallor,
spooning of nails, pulse oximeter, HR - tachycardia,
murmur, splenomegaly
, Treatment: OTC - iron supplements Severe: may
need transfusion
Sickle Cell Disease (SCD)
• abnormal Hgb gene
• sickle shaped RBC's
• autosomal recessive disorder
• ethnically linked (African, Mediterranean,
Hispanic, Middle Eastern, Asian)
• HgB is protectant for the first 4-6 months of life
• occlusion and hemolysis
• premature RBC death (low RBC counts, hemolytic
anemia)
Sickle Cell Crisis
• triggered by hypoxia, acidosis, dehydration,
fever, and hypothermia
vasoocclusive : severe pain from ischemia
and dactylitis (swelling of fingers or toes)
Splenic Sequestration : blood gets trapped in
the spleen
Silent Cerebral Infarct : neuro assessment,
stroke or silent cerebral infarct
Acute Chest Syndrome : pulmonary vessel
occlusion; mimics pneumonia but infarcts and not
infiltrations
Sickle Cell Treatment
