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Aplastic Anemia:
Cause
External causes
- Absent/abnormal stem cell production
- Decreases in RBC, WBC and platelets
- Idiopathic (50%)
- Drugs/toxins
- Radiation
-
Aplastic Anemia:
Consequences of decreased RBC, WBC and platelets?
What's going on with the spleen?
RBC - pale, weak
WBC - infection, mouth sores
Platelets - bruising
No enlarged spleen compared to iron deficiency anemia (key difference)
-
Aplastic Anemia:
Tx
Meds
Prognosis
Remove drugs/toxins
- Non-HCT - methylprednisolone, ATG, cyclosporine
- HCT
High risk of late malignancies, AML and MDS
-
Idiopathic Thrombocytopenia Purpura:
Cause
Associated with a history of
S/S
- Excessive destruction of circulating platelets
- (less than 100,000)
Viral infection within 2-4 weeks
- Bruises in a healthy looking child
- (be careful in assuming child abuse)
-
Idiopathic Thrombocytopenia Purpura:
Tx
Prognosis
- No therapy just use safety precautions if platelets are above 30,000
- Steroids if below 30,000
- IgG if below 10,000
95% resolve by 6 months
-
When both parents have the sickle cell disease trait what are the chances of:
A healthy child
Trait carriers
Having the disease
- 1:4 health
- 2:4 carriers
- 1:4 disease
-
Sickle Cell Disease:
Correlated to environments with
Immune to
Cause
High incidence of malaria
Malaria
Abnormal hemoglobin that is deoxygenated
-
Sickle Cell Disease:
Complications
Emergencies
Vaso-occlusive crisis, sequestration, aplasia
CVA, acute chest syndrome, priapism
-
What is leukemia?
Immature WBC that crowd normal cells
-
Childhood leukemia:
Type
Age peak
% leukemia
% cancer
ALL - 2-4years - 75% - 25%
AML - neonate/teen - 20% - 5%
CML - none - 5% - 1%
-
Leukemia:
WBC
Platelets
Hemoglobin
Dx from labs?
WBC - any range
Plt - decrease
Hgb - decrease
Typically can NOT dx from labs
-
What is the most common type of ALL?
Precursor B Cell
-
What is the most common primary malignant renal tumor?
Wilms Tumor
-
Wilms Tumor:
S/S
- Nontender, firm fragile gelatinous capsule
- Abdominal pain
- Vomiting
- Hypertension
-
Wilms Tumor:
Tx
- Nephrectomy
- Chemo
- Radiation
-
Wilms Tumor:
Prognosis
Recurrence
90%
50%
-
Retinoblastoma:
Favored sex or race?
90% are diagnosed by age?
No
5 years
-
Retinoblastoma:
Tx
Prognosis
- Laser cryotherapy
- Chemo
- Radiation
- 90%
- (most deaths are from secondary malignancies)
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