| Show Learning Points most relevant to Phase 1: |
Infant or child with pallor
| Clinical Discipline(s)/Organ System(s) Haematology, Paediatrics | Progress Test Topic(s) Blood and lymph |
Description
A 12 month old Samoan boy is brought to see you by his grandmother and mother. His grandmother is visiting and hadn't seen him for 4 months; she has noticed that he is pale and has encouraged his mother to take him to the doctor.
Progress Test-Type Questions: Question 1 | Question 2Applied Science for Medicine
- Normal and abnormal haematopoiesis
- Normal nutrition and growth (iron, vitamin B12/folate, vitamin D)
- Acquired and inherited disorders of red cells and bone marrow
- Genetic basis of red cell disorders (e.g. thalassaemia, sickle cell anaemia)
- Normal and abnormal haematopoiesis
- Normal nutrition and growth (iron, vitamin B12/folate, vitamin D)
- Acquired and inherited disorders of red cells and bone marrow
- Genetic basis of red cell disorders (e.g. thalassaemia, sickle cell anaemia)
Clinical and Communication Skills
- Identify common types and causes of anaemia in infancy and childhood
- Recognise shock (or impending shock) in infants and children
- Use of history, physical examination and basic laboratory tests to diagnose causes of anaemia
- Interpret full blood count, inflammatory markers, iron studies, Coombs test
- Importance of iron deficiency long-term (effects on learning, diminished immune response to infection)
- Dietary history; advice and iron prescription (adherence, safety, overdose)
- How to assess pallor
- Identify common types and causes of anaemia in infancy and childhood
- Recognise shock (or impending shock) in infants and children
- Use of history, physical examination and basic laboratory tests to diagnose causes of anaemia
- Interpret full blood count, inflammatory markers, iron studies, Coombs test
- Importance of iron deficiency long-term (effects on learning, diminished immune response to infection)
- Dietary history; advice and iron prescription (adherence, safety, overdose)
- How to assess pallor
Personal and Professional Skills
- Communicate empathetically with child and caregivers
- Explain diagnosis including genetic aspects where appropriate (e.g. carrier status in thalassaemia) to parents
- Evaluation of social history including dietary and financial stressors
- Acknowledge impact of illness on family/whānau employment/income
- Communicate empathetically with child and caregivers
- Explain diagnosis including genetic aspects where appropriate (e.g. carrier status in thalassaemia) to parents
- Evaluation of social history including dietary and financial stressors
- Acknowledge impact of illness on family/whānau employment/income
Hauora Māori
- Higher rates of anaemia among Māori (and Pacific, ‘Other’) infants than Pākehā
- Lower rates of breastfeeding among Māori
- Awareness of Whānau dynamics (who is/are carers)
- Ability to cater for differential health literacy needs of Māori patients and whānau
- Awareness of differing risk profiles for Māori (and other disadvantaged populations) compared with non-Māori in NZ relevant to anaemia in children including deprivation, chronic infection
- Higher rates of anaemia among Māori (and Pacific, ‘Other’) infants than Pākehā
- Lower rates of breastfeeding among Māori
- Awareness of Whānau dynamics (who is/are carers)
- Ability to cater for differential health literacy needs of Māori patients and whānau
- Awareness of differing risk profiles for Māori (and other disadvantaged populations) compared with non-Māori in NZ relevant to anaemia in children including deprivation, chronic infection
Population Health
- Poverty, health literacy and nutrition
- Immigrant health and screening for genetic traits (e.g. G6PD deficiency and thalassaemia traits in Asian/Mediterranean families)
- Most common world population causes for anaemia (sickle cell, thalassaemia and iron deficiency)
- Poverty, health literacy and nutrition
- Immigrant health and screening for genetic traits (e.g. G6PD deficiency and thalassaemia traits in Asian/Mediterranean families)
- Most common world population causes for anaemia (sickle cell, thalassaemia and iron deficiency)
Conditions to be considered relating to this scenario
Common
hypochromic microcytic anaemia (iron deficiency; thalassemia)
hypochromic microcytic anaemia (iron deficiency; thalassemia)
Less common but 'important not to miss'
leukaemia and other malignancies, anaemia of chronic disease, anaemia of chronic renal disease, lead poisoning
leukaemia and other malignancies, anaemia of chronic disease, anaemia of chronic renal disease, lead poisoning
Uncommon
haemolytic anaemias (hereditary spherocytosis, G6PD deficiency, autoimmune disease)
haemolytic anaemias (hereditary spherocytosis, G6PD deficiency, autoimmune disease)
