Therapeutic management of a 6-year-old child with hereditary ...

[mwit1967]

Therapeutic management of a 6-year-old child with hereditary spherocytosis (HS) should include which therapeutic intervention?
 
  a. Perform a splenectomy.
  b. Supplement the diet with calcium.
  c. Institute a maintenance transfusion program.
  d. Increase intake of iron-rich foods such as meat.

Question 2

What statement best describes iron deficiency anemia in infants?
 
  a. It is caused by depression of the hematopoietic system.
  b. Diagnosis is easily made because of the infant's emaciated appearance.
  c. It results from a decreased intake of milk and the premature addition of solid foods.
  d. Clinical manifestations are related to a reduction in the amount of oxygen available to tissues.

[sultana.d]

Answer to Question 1

ANS: A
Splenectomy corrects the hemolysis that occurs in HS. The splenectomy is generally reserved for children older than age 5 years with symptomatic anemia. Supplementation with calcium does not affect the HS. Additional folic acid can prevent deficiency caused by the rapid cell turnover. A maintenance transfusion program suppresses red blood cell formation. At this time, the risks of transfusion are greater than those of a splenectomy. Iron supplementation does not influence the course of HS.

Answer to Question 2

ANS: D
In iron-deficiency anemia, the child's clinical appearance is a result of the anemia, not the underlying cause. Usually the hematopoietic system is not depressed. The bone marrow produces red blood cells that are smaller and contain less hemoglobin than normal red blood cells. Children who have iron deficiency from drinking excessive quantities of milk are usually pale and overweight. They are receiving sufficient calories but are deficient in essential nutrients. The clinical manifestations result from decreased intake of iron-fortified solid foods and an excessive intake of milk.

[mwit1967]

TYSM

[marict]

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