Presentation

Pallor / Anemia

Key Conditions

Key conditions are the core conditions that the Paediatric Undergraduate and Clerkship Directors of Canada (PUPDOC) felt are essential for graduating medical students to know. The Key Conditions are neither a differential diagnosis nor a clinical approach. They highlight conditions that may be unique to paediatrics, that are essential, or that are common. Key Conditions can present in a number of ways – each is listed as under the most common Clinical Presentation.

Clinical Approach

Clinical approaches represent one of many methods to think through a clinical presentation, and narrow down a differential diagnosis. There are many conditions that can present with similar symptomatology. These presentations are not meant to contain an exhaustive list of differential diagnoses, but rather outline how to think through patient signs and symptoms, and understand some of the most common and important Paediatric conditions. There are many different ways to approach any clinical presentation, and these approaches are not meant to replace clinical judgement.

Vignette

A 4 year old male is brought to medical attention by his grandfather, after he noticed that he is looking increasingly pale and fatigued

Diagrams

Pre-Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Lectures

  • Thalassemia Course 1
  • Sickle cell anemia Course 1
  • Hematology: Common Pediatric Concerns Course 1
  • Hemolysis Course 1
  • Pancytopenia Course 1
  • Macrocytic and microcytic anemia Course 1

Small Groups

  • Microcytic anemia Course 1

Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Objectives

By the end of the Paediatric Clerkship, a medical student will be able to:

  1. Describe the physiologic consequences of anemia.
  2. Interpret a CBC and differential and iron studies.
  3. Recognize the clinical features and propose a management plan for patients with iron deficiency anemia.
  4. Recognize the clinical features of hemolysis and hemoglobinopathies.

Half Day Cases

  • A 6 year old is brought in to your clinic. She has been easily fatigued over the last 4 weeks. The grandparents just came for a visit, and noticed that she is extremely pale, and advised parents to bring her in to see you.
  • You are seeing an 8 year old child in the hospital for pneumonia. You notice on their initial CBC that he has a hemoglobin of 110, MCV 68. You wonder what may be causing his microcytic anemia
  • A 2 year old child comes into your clinic for their routine well-child visit. On your history, you learn that the child drinks a lot of cow's milk, and looks pale to you.

Resources

The following resources have been reviewed and collated by canuc-paeds. These resources are aimed to provide information at the level of the medical student. These include overviews of topics, clinical resources, and useful guidelines that contain relevant materials.

Papers 

  • Evaluation of anemia in children. . Janus J et al. .
    ; American Family Physician 2010; 15(12): 1462-1471. http://www.aafp.org/afp/2010/0615/p1462.html.
    Good basic article with flow diagrams capturing diagnosis based on age and MCV.

Videos 

No videos.