Important knowledge

⚡️chronic anemia affects growth (as thalasemia) so the child will have FTT

⚡️Spherocytosis presented with classic hemolysis triangle & history of prolonged neonatal jaundice

⚡️Important things in family history of hemolytic anemia ▪︎History of blood transfusion in family ▪︎spleenectomy in family ▪︎cholecystectomy in family !

⚡️hepatitis A is presented with hemolytic anemia ( hemolysis )in 15% of cases [witch is difficult do diagnosed )]

⚡️Risk factors for hemolysis ih G6PD to be asked (د.مناف) ▪︎Foods ( اي شي بالبقوليات اخضر ) -باقلاء (مو اله ماكلها ممكن طابخين ومشتمها ) -فاصوليا خضرة -لوبيا خضرة -بزاليا خضرة ▪︎married parity ( ومخلي حنة ) ▪︎recent medications (as Antibiotics ) ▪︎ stressful events (as flue )

⚡️hemolytic anemia triangle ▪︎pallor ▪︎jaundice ▪︎dark color urine " It is emergency case "

⚡️Normal HB in neonate is 16 -20 g/dl (د.مناف)

⚡️Hyperglycemia (neonatal DM ) is rare neonate & it is mostly disappear at age of 1 Y (even if continue on insulin)

⚡️Neonatal sepsis can cause bon marrow suppression that lead to = Anemia or bleeding

⚡️Any infection in neonate is considered as neonatal sepsis ( د. مرتضى )

⚡️prolonged jaundice in neonate + down syndrome = hypothyriodism (think about it )

⚡️symptoms of factor 13 deficiency : ▪︎delay stamp separation ▪︎abortion ▪︎abnormal clotting (ينجرح اليوم ينزف باجر)

⚡️Factors that not produced by liver is vonwillbrand & factor VIII (partialy from liver )

⚡️when u decide to give steriod for patient with ITP u should do bone marrow aspiration before 《to exclude Leukemia which get benefit to steriod alone in 15% of cases [ and that reduce the chance of cure of Leukemia] 》 (د.رباب)

⚡️How u can differentiate between Aplastic anemia Leukemia ITP from history (all presented with bleeding)? 🤔 ( مهم اوسكي ) ▪︎ Aplastic anemia = long history of paller & repeated infections ▪︎Leukemia = (as Aplastic) but intermediate duration history with more acute & more serious presentation ▪︎ITP (Immune thrombocytopenia purpura) = short history of bleeding only

⚡️child with pallor & history of neonatal Jandice think about : ▪︎G6PD ▪︎Spherocytosis

Features of Fanconi anemia (congenital aplastic anemia) واجب اطلاع د.رباب

●Fever + Rigor + Sweating = think about malaria (Ask about history of travel)

⚡️Non anemic causes of pallor ▪︎Cardio = heart failure ( بعد كل رضعه يصير وجهه شاحب ويتعرق ) ▪︎ Respiratory = RDS

⚡️palpable spleen above 5 Y.O of age exclude sickle cell anemia (due to auto-spleenectomy in sickle which is almost occour before 5 Y age )