Blood and Immune Peds

  1. What are immature neutrophils called and what triggers them to be released?
    Bands or Left Shift: released by bacterial infection and acute inflammation
  2. These non-specific immune response are considered "1st responders." They act by phagocytosis of bacteria and respond with acute inflammation, bacterial infection and ncrosis.
  3. What do Eosinophils do?

  4. What do Basophils do?

  5. What do Monocytes do?

  6. T or F: Eosinophils are called "mast cells" if they are in tissue
    False: Basophils are
  7. These Lymphocytes (B or T?) are 1st responders for viral infections and produce antibodies to bacteria.
    B Lymphocytes
  8. These Lymphocytes (B or T) responds to viruses, fungi, parasites, and foreign tissue
    T Lymphocytes
  9. What are the three types of T Lymphocytes?
    • 1. Suppressor T cells
    • 2. Cytotoxic cells
    • 3. Helper or CD4
  10. Certain T cells are needed to secrete substances that are specific to an antigen, which bind to B cells. 

    What does the B cell do after this?
    The B cell will produce antibodies that are specific for that antigen
  11. This term is an immune response that does not involve antibodies, but rather involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen.
  12. T or F: Active immunity lasts for only a few weeks or months. However, passive immunity, like IgG from the placenta, is long lasting.
    False: Only active immunity is long lasting
  13. Passive immunity will dissipate by ___ months.
    6-9 months, dependent on level in maternal plasma
  14. This immunoglobulin contains antibodies against germs (70-80%). It crosses the placenta, and is longer and stronger.

  15. This immunoglobulin is the first produced antibody after an infection (first 48-72 hours). It is also responsible for transfusion reactions.

  16. This antibody provides protection across mucous membranes, especially as an antiviral. It can be passed on to newborns from breast milk.

  17. This antibody releases histamines in an allergic rxn. It also plays a role in parasite defense.

  18. What is the acronym ART used to treat? What does it stand for?
    Antiretroviral Therapy: for infected moms with HIV and has decreased vertical transmission in pregnancy.
  19. Antiretroviral Therapy (ART) is given to infants of mothers with HIV for how many weeks?
    6 weeks
  20. This abx is used as a prophylaxis with PCP/HIV
  21. What is PCP and who is at highest risk?
    Pneumocystis Pneumonia: a life-threatning infection that occurs in immunocompromised patients. 

    HIV patients with a low CD4 count are at the highest risk
  22. Hematologic System: Decrease in circulating O2 will stimulate the kidneys to produce this __a__. What does it do?
    Erythropoieten: stimulates RBC precursors and cause the to mature rapidly
  23. This is a blood disorder that reduces the production of hemoglobin. 

  24. This is an inherited bleeding disorder in which a person lacks clotting factors and cannot stop cuts or bleeds normally.

  25. This is a lifelong bleeding disorder in which the blood doesn't clot well. They are missing a clotting protein. 

  26. This is a clinical syndrome in which a decreased number of circulating platelets will increase bleeding tendency and bruising.

    C. ITP (Immune Thrombocytopenia)
  27. What is Disseminated Intravascular Coagulation? (DIC)

    What complication can it cause?
    A condition in which blood clots form throughout the body's small blood vessels. 

    The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding.
  28. T or F: You can introduce cow's milk to a child only after 9 months
  29. T or F: Calcium will help increase absorption of Iron
    False: Vitamin C helps increase absorption
  30. Which vitamin helps increase Iron absorption?
    Vitamin C
  31. T or F: Black, tarry stools are an indication of Iron deficiency
    False: They are common when taking iron rich or iron supplemnts
  32. How are abx used with infants that have sickle cell disease?
    Children when they are about 2 months old will may begin taking Penicillin until they are about 5 years old to help revent PNA.
  33. What is the difference between Thalassemia minor, 1 gene vs. 2 genes?
    • 1 gene: will have mild s/s, also called beta-thalassemia
    • 2-gene: s/s will be moderate to severe .
  34. When treating Thalassemia, a patient may require a blood transfusion. What is the medication used to help remove excess iron?
    Deferasirox Exjade, Jadenu)
  35. Match the Hemophilia type with the clotting factor:

    1. Hemophilia A
    2. Hemophilia B
    3. Hemophilia C

    a. CF XI
    b. CF VIII
    c. CF IX
    d. CF XII

    Which type is the most common?
    • 1. b
    • 2. c
    • 3. a

    Most common is type A
  36. With this clotting factor dz, bleeding is more common in muscles and joints
  37. With this bleeding dz, DDAVP (hormone desmopressin) is injected to stimulate the release of more clotting factors.
  38. This is the destruction of platelets by autoantibodies. What sudden manifestations will it follow?
    ITP: bruising, petechiae, bleeding mucous mmbranes
  39. ITP is the destruction of platelets by autoantibodies. What is the biggest danger from it?
    Low platelets (<10,000) leading to intracranial hemorrhage
  40. What is the treatment of choice for aplastic anemia (bone marrow ceases production of cells)?
  41. What is aplastic anemia?
    Bone marrow ceases production of cells
  42. List 5 therapeutic management of cancer
    • 1. Chemo
    • 2. Surgery
    • 3. Radiation
    • 4. BMT
    • 5. Stem cell transplant
  43. This form of cancer tx non-selectively kills rapidly dividing cells. It can be given PO, IM, IV, SQ, IT.
  44. What are the most affected body systems of chemotherapy?
    • Hematopoietic system (system for production of blood like bone marrow)
    • GI 
    • Integumentary (skin, hair, etc)
  45. Typically after 7-10 days of chemo, this can occur ___. What is is the greatest concern?
    Nadir: Lowest point of blood cell count

    Greatest concern is infection, typically opportunistic infection (non-pathogenic bacteria/fungi already found on us)
  46. T or F: with bone marrow suppression folowing chemo therapy and nadir, you will not see inflammation occur during an infection
    True, no redness, swelling or drainage, only a fever
  47. How is GI affected from chemo?
    • n/v
    • anorexia - caused by n/v and change in taste (metallic taste)
    • mucositis (pain in mucous membranes)
    • Yeast (non-pathogenic) gets into blood stream causing infection
  48. What are the different surgical interventions for managing cancer?
    • Biopsy or removing/debulk mass
    • Placing a central line/port-a-cath
    • Sometimes unable to debulk until after shrinking via chemo
  49. Is a change in gait an overt or covert sign of cancer?
  50. T or F: Overt signs of cancer are things that are out in the open, like whitish reflex in the eye
  51. T or F: Bone pain and headaches are overt signs of cancer
    False: covert
  52. This form of cancer tx is given to eradicate disease or palliatively in low doses to prevent further growth of tumor
    Radiation therapy
  53. What is the most common cancer in kids <15 yo? What is its most common form?
    Leukemia - proliferation of immature WBC

    Most common form: Acute Lymphoblastic Leukemia
  54. This form of cancer of your blood cells caused by a rise in the number of white blood cells in your body. They crowd out the red blood cells and platelets your body needs to be healthy.
  55. What are common sites of infiltration of Leukemia?
    CNS and the testicles (often sites of relapse)
  56. What are the treatment phases of Leukemia? (3)
    • 1. Induction: not a cure, but the goal is to achieve remission when leukemia cells are no longer found in bone arrow. (This also includes intrathecal chemotherapy into CSF to kill any leukemia cells that spread to brain and spinal cord)
    • 2. Consolidation: More intense phase of chemotherapy, reducing # of leukemia cells still in the body. 
    • 3. Maintenance: if leukemia remains in remission after induction and consolidation, maintenance therapy begins. Most treatment plans last up to 2-3 years.
  57. T or F: brain tumors rarely metastasize in other areas outside the brain and spine
  58. What are hallmark s/s of brain tumors?
    • H/A
    • morning vomiting when getting out of bed r/t increased ICP
  59. When is osteosarcoma have been known to "peak" in growth? Which areas can they be typically found in?
    • Can peak in teenage years r/t rapid bone growth.
    • Femur, tibia, humerus
  60. This other cancer is similar to osteosarcoma (cancer in the bones) but it can invade soft tissue too.
    Ewing's Sarcoma
  61. Match:
    1. Influence inflammatory process, #s increase w/ allergic rxn or parasitic invasion
    2. Activates the inflammatory process by secreting histamines, called MAST cells in tissue
    3. Ingest/introduce antigens into circulation, fights chronic infection

    a. Eosiniphils
    b. Monocytes
    c. Basophils
    • 1. a
    • 2. c
    • 3. b
  62. Which of these three will Diphenhydramine (anti-histamine) slow down?

    B. Basophils: activates the inflammatory process by secreting histamines during inflammation
  63. Which Immunoglobulin will be looked at when looking for an autoimmune disease?
  64. which steroid is used as an antiinflammatory and for cancer tx?
  65. What are causes of a "sickle-cell crisis"
    • Infection
    • Dehydration
    • Hypoxia
    • Trauma
    • General Stress
  66. What should a neonate receive before going through a circumcision?
    Vitamin K
  67. T or F: seeing a red mark reflex on an infant's eye during an eye exam indicates a improper perfusion.
    False: white reflex
  68. What is Nadir? What are considerations?
    • The lowest point of WBC production 
    • Greatest concern is infection; opportunistic infeciton caused by our normal flora
  69. This tx kills rapid dividing cells. How can the normal cells be affected in a normal child?
    Radiation therapy: can cause cognitive, deveclopmental problems 

  70. What is the most common Leukemia?
    Acute Lymphoblastic Leukemia (ALL)
  71. This drug is given for both carcinomas and severe inflammatory diseases (like Juvenile Arthritis)
  72. This type of cancer peaks in teen years rapid growth and puberty. It presents with unresolved pain.
Card Set
Blood and Immune Peds
Exam 4 Lecture notes