The Children's Hospital Oakland Hematology/Oncology Handbook

INTRODUCTION

Chapter 1 - Objectives

Resident Responsibilities ANEMIA

Chapter 2 - Evaluation of Anemia

Table 1 Normal RBC Values

Table 2 Diagnostic Approach

Table 3 History

Table 4 Physical Exam

Table 5 Evaluation of Iron Deficiency

Oral Iron Challenge

Parenteral Iron

Erythropoietin

Algorithm 1 Approach to Child with Anemia

Algorithm 2 Diagnostic Approach to the Child with Microcytic Anemia

Algorithm 3 Approach to the Newborn with Anemia

Chapter 3 - Helolytic Anemia

Algorithm 4 Approach to the Child with Hemolytic Anemia

Chapter 4 - Sickle Cell Disease

Fever and Infection

Algorithm 5 Fever in a Child with Sickle Cell Disease

Vaso-Occulusive Episodes

Pain Management:

Outpatient

Inpatient

Acute Chest Syndrome

Algorithm 6 Sickle Cell Disease with Acute Pulmonary Infiltrate

Priapism

Stroke

Splenic Sequestration

Aplastic Crisis

Avascular Necrosis

Retinopathy/Hyphema

Hyperbilirubinemia

Peri-Operative Care

Table 6 Immunization Recommendations

Chapter 5 - Thalassemia

Table 7 Classification of the Thalassemias

Alpha Thalassemia

Table 8 Alpha Thalassemia Syndromes

Beta Thalassemia

Table 9 Summary of Common Thalassmia Syndromes

Neonatal Screening

Management of Chronically Transfused Patients TRANSFUSION THERAPY

Chapter 6 - Blood Products

Red Blood Cells

Sickle Cell Disease

Oncology

Platelets

Granulocytes

Plasma

Preparation of Blood Products

Chapter 7 - Transfusion Reactions

Table 10 Drugs used in the Treatment of Nonhemolytic Transfusions

Reactions

Chapter 8 - Chelation Therapy

Desferal Desensitization Protocol THE CHILD WITH A BLEEDING DISORDER

Chapter 9 - Initial Evaluation

Table 11 Obtaining a Bleeding History

Table 12 Interpretation of Laboratory Studies

Algorithm 7 Laboratory Evaluation of the Bleeding Child

Chapter 10 - Inherited Bleeding Disorders

von Wilebrand's Disease

Factor VIII Deficiency

Factor IX Deficiency and Other Rare Coagulation Deficiencies

Chapter 11 - Management of Acute Hemorrhage

Treatment of vWB Disease and Hemophelia

Factor Administrative Instructions THE CHILD WITH THROMBOSIS

Chapter 12 - Evaluation of the Child with Thrombosis

Low Molecular Weight Heparin Therapy

Table 13 Age-Dependent Dose of Enoxaparin NEUTROPENIA

Chapter 13 - Neutropenia

Algorithm 8 Approach to the Child with Neutropenia THROMBOCYTOPENIA

Chapter 14 - Immune-Mediated Thrombocytopenia

Neonatal Alloimmune Thrombocytopenia

Table 14 Differential Diagnosis of Thrombocytopenia

Algorithm 9.1 Approach to the Child with Thrombocytopenia

Algorithm 9.2 Approach to the Child with Isolated

Thrombocytopenia

Algorithm 9.3 Approach to the Child with

Thrombocytopenia/Anemia

Chapter 15 - Non-Immune Mediated Thrombocytopenia

Decreased Platelet Production THE CHILD WITH A MALIGNANCY

Chapter 16 - Presentation and Initial Evaluation

Table 15 Common Chief Complaints

Table 16 Presenting Signs and Symptoms

Table 17 Indications for Head CT with Headache

Evaluation of the Child with Suspected Leukemia

Evaluation of the Child with an Abdominal Mass

Chapter 17 - Supportive Care

General Measures/Prophlaxis

Table 18 Ondansetron (Zofran) Dosing Guidelines

Table 19 Immunization of the Children with Cancer

Table 20 Passive Immunization of the Children with Cancer

Table 21 A Quick Guide to Common Chemotherapy Drugs

Guidelines for use of G-CSF

Chills and Fever After a Broviac or Mediport Flush

Guidelines for Clearing Obstructed Central Venous Catheters

Chapter 18 - Fever and Neutropenia

Algorithm 10 Evaluation of the Child with Fever and Neutropenia

Chapter 19 - Oncologic Emergencies

Superior Vena Cava Syndrome

Abdominal Emergencies/Typhlitis

Hyperleukocytosis

Tumor Lysis Syndrome

Chapter 20 - Guide to Oncologic Procedures

IT Chemotherapy

Intra-Ommaya Chemotherpay

Bone Marrow Aspirate and Biopsy

Chemotherpay (per PIV) APPENDIX

Formulary INDEX