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SCC q

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robin082006
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03/22/07 - 05:23 PM

4- 2 wk old boy is brought for check up. He’s been doing well at home. Results of his newborn screen shows he has sickle cell dis. What’s the most important step in his Mx?
A- avoiding heat exposure
B- immunization with pneumococcal vaccine
C- folic acid supplements
D- iron supplements
E- prophylactic penicillin

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doc_clotaire
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03/22/07 - 05:41 PM

B

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nadiabarati

03/22/07 - 06:25 PM

cold exposure, dehydration, acidosis, infection can cause hemolysis crisis.

penicillin prophylaxis starts at 4 months of age

immunization with Hib and heptavalent PCV are given at 2, 4, 6 months of age and then at 12-15 months of age. 23 valent PCV is given at 2 years of age and then at 4-6 years of age.

So I go with C) folic acid supplementation....because folic acid is needed for all chronic anemias

robin082006
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03/22/07 - 06:27 PM

try again, both of u

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nadiabarati

03/22/07 - 06:33 PM

no other idea!

robin082006
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03/22/07 - 06:48 PM

Answer is E

for SC anemia--> increased risk of pneumococcal infection---->pneumococcal vacine or Penicilline prophylaxis

but Pneumococcal vacine is not recommended for children <2yo-->rule out B

Penicilline is not contraindicated-->answer

folic acid is used to prevent aplastic crisis but not firstv step for SC anemia.

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muna
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03/22/07 - 06:49 PM

A?Beacause excess heat -dehydration

nadiabarati

03/22/07 - 07:46 PM

but the baby is 2 weeks-old!! and penicillin prophylaxis starts at 4 months of age!!

neuroblastoma
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03/22/07 - 11:28 PM

Robin,, is nadia's statement correct??? do u agreed?

robin082006
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03/22/07 - 11:33 PM

#10

neuroblastoma wrote:
Robin,, is nadia's statement correct??? do u agreed?

Why do you have to wait until 4th month of age? preference ?

Penicilline is a safe drug (unless allergic), can use at any age in no contraindication.

this is Kap q

Edited by robin082006 on 03/22/07 - 11:54 PM

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nadiabarati

03/23/07 - 06:16 AM

#11

blueprints pediatrics 2007 on page 133 says: children with sickle cell disease start penicillin prophylaxis at approximately 4 months of age and receive vaccinations.

the reason is: at approximately 4 months of age, the percentage of hemoglobin F diminishes and the percentage of hemoglobin S rises.

shabee
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05/10/07 - 04:26 PM

#12

so what pencillin has to do with s and f ???????????

NE
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05/10/07 - 05:21 PM

#13

Penicillin has to do with splenic function( and with possible infections!)- if the kid has Hb F the risk for splenic dysfunction is very low; after 6 M when HbS is predominant the risk of sickle crisis and splenic infarction increases!
Anyway I don't know where I saw this q before but there the answer was even if I picked up C!

sandra
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07/17/07 - 03:01 PM

#14

whats the answer?

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khorshid
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07/17/07 - 07:28 PM

#15

I thought it's E too. raised eyebrow

dr in trouble
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07/17/07 - 11:01 PM

#16

the answer is E

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