11. PATHOPHYSIOLOGY
Supply of inadequate iron
Depletion of iron stores
Depletion of serum transferrin concentration
Subnormal Hb concentration
Subnormal oxygen carrying capacity
12. CLINICAL
MANIFESTATIONS
⢠Pallor, Anorexia, Irritability
⢠Palpitation, shortness of breath, fatigue
⢠Atrophy of tongue
⢠Koilonychias in older children
⢠Organomegaly
⢠Lack of attention span
⢠Pica
⢠Growth retardation
⢠Impaired mental and physical functions
16. Oral iron therapy
⢠Recommended Dosage
⢠Infant and children:3 mg/kg/day
⢠20mg elemental iron +100 mcg folic acid
⢠Adolescent :100 mg elemental iron +500 ¾g of folic acid +25-50 mg
vit.c
Mild Anemia: Once Daily
Moderately And Severe Anemia: Twice
Daily
Mild Anemia: Once Daily
Moderately And Severe Anemia: Twice
Daily
Result
Peak increase of reticulocyte count in 5th
-10th
day of administration
Result
Peak increase of reticulocyte count in 5th
-10th
day of administration
18. ⢠Iron dextran complex:50 mg/ml in 2ml saline
⢠Dose calculation:
⢠Route=intramuscular---Z track method
intravenous-----infusion methods
Iron [mg]= Wt. in kg x Hb deficit [gm/dl] x4
19. Transfusion
therapy
⢠Given when Hb is <3-4 gm/dl
⢠Packed red cell 2-3 ml/kg
Note:
Infuse at slow rate to prevent cardiac
overload, a dose of frusemide 1-2mg/kg IV
is given during transfusion
20. Diet therapy
⢠Good sources of iron:
⢠legumes
⢠nuts,
⢠Green leafy veg.
⢠dates,
⢠yolk of egg,fish, meat, liver,
⢠ripe banana, mango
⢠Cooking in iron pots
⢠Poor source of iron:
⢠Milk
⢠Administer iron with
fruit juices
⢠iron with milk or
antacids
21. Health
education
⢠Diet counseling for parents
⢠Iron fortified formulas
⢠Limitation of milk
⢠Avoid beverages like tea
⢠Colour changes of stool
⢠Staining of teeth
⢠Deworming
22.
23. Definition
⢠Sickle Cell Anemia Is An Autosomal
Recessive Order In Which Normal
Adult Hb A Is Partly Or Completely
Replaced By Abnormal Sickle Hb[Hb S]
34. APLASTIC CRISIS
⢠DIMINISHED PRODUCTION OF RBC
⢠ACCELERATED RATE OF RBC
DESTRUCTION
⢠DUE TO BLOCKAGE OF MAJOR VESSELS
HYPERHEMOLYTIC CRISIS
CVA
37. Diagnosis
⢠New born screening
⢠Chronic villus biopsy
⢠Hb electrophoresis
⢠Sickle turbidity test
⢠Iso electric focusing
⢠High performance liquid chromatography
⢠Globin DNA analysis
43. THALASSEMIA
Thalassemia is an autosomal recessive,
characterized by decreased synthesis of
one of the polypeptide chains [ or ]ι β
that form normal adult haemoglobin
molecule
57. Methods of transfusion
Method Hb level Maintenance level
Palliative <7gm% <8.5 gm%
Hyper transfusion >10 gm% >12 gm%
Super transfusion >12mg% >14gm%
Moderate transfusion 9-10gm% >12gm%
Post transfusion Hb level should not be >16gm/dl
58. Iron Chelation therapy
Drugs used are:
⢠Desferrioxamine:30-40 mg/kg/day
⢠Deferiprone:75-100 mg/kg/day
⢠Desferasirox :20 -40mg/kg/day
When to start?
After 10-20 blood transfusion