1) newborn screen to detect sickle cell disease/trait

2)9-12 mo when fetal stores or depleted

3) menstrating adolescents

4) lead screening at 1 year

Vitamin B 12 deficiency****

Folate deficiency

Aplastic anemia

correction of dietary supplements is tx of choice

MOST COMMON ANEMIA IN CHILDREN

1. anemia of chronic disease
2. Iron deficiency anemia
3. Thalassemia
4. Congenital disorder
5. Lead poisoning
6. Blood loss
7. Infection
8. Cancer

Iron Deficency Anemia

Microcytic Anemia***

Hgb or Hct >2 SD below normal

• rare before 6mo
• due to insufficent dietary iron for expandign blood volume
• Lab values: microcytic, low mcv, low rbc, high rdw, low ferritin
• clinical manifestations: Pallor (gums), decreased energy, irritability, tachycardia, systolic murmur.
• Mgmt: Elemental iron 4-6mg/kg/day divided in to 1-3 doses daily. Recheck H&H monthly should rise 1g/dl continue for 2-4 months after return to normal.

Factor VIII deficiency

x-linked

mostly males

Idiopathic Thrombocytopenia

(ITP)

• Most common acquired platelet disorder
• Immune response usuall seen after viral illness
• Diagnosis of exclusion
• Plt count <20,000
• Classic signs: purpura, petechiae, mucocutaneous bleeding

Henoch-Schonlein Purpura

(HSP)

Boys ages 2-7 fall and spring, follows URI

corps of maculopapules that progress to purpuric rash on lower extremities and buttocks; joint and bowel inflammtion.

You have ordered a red blood cell indices for a 10 year old girl. Results reveal a decrase in both the mean corpuscular hemoglobin (MCH) and the mean corpuscular volume (MCV). Differential diagnosis should include:

a) sickle cell anemia

b) Vitmain B 12 deficiency anemia

c) Pernicious anemia

d) Iron deficency anemia

You have prescribed iron supplements for a 3-year-old-child when instructing the parents about how to give the iron it is important to tell them that iron:

a) is best absorbed on an empty stomach

b) is best absorbed when given with meals

c) is best abosrbed when given with milk

d) should not be given with bedtime