Pale child

Question 1

Discuss pathophysiology of pallor

Answer 1

Hypoperfusion - decreased CO, hypovolaemia, loss of vascular tone - vasodilatation
Anaemia
Metabolic - hypoglycaemia
Oedema - loss of fluid into the third space
Allergy - oedema under inferior border of orbits

Question 2

Discuss how you would approach a pale child

Answer 2

Determine whether pallor is acute or chronic
History - duration and other associated symptoms
Determine the vital signs
Observe the colour of the child
skin - not a good indicator for anaemia
mucous membranes of the mouth
conjunctiva
creases of hyperextended hand
Determine the primary affected system
Plan the investigations and or management

Question 3

Discuss pathophysiology of anaemia

Answer 3

Decreased haemoglobin 
Decreased production of RBC 
Haemolysis - metabolic 
Increased destruction - at the spleen 
Chronic blood loss - leukaemia

Question 4

Microcytic anaemia - MCV < 80

Answer 4

iron deficiency anaemia
thalassemia
anaemia of chronic disease

Question 5

Normocytic anaemia - MCV 80-100

Answer 5

hypoproliferative - leukaemias, aplastic anaemia

hyper proliferative - haemorrhage, hemolytic anemias

Question 6

Macrocytic anaemia - MCV > 100

Answer 6

megaloblastic anaemia - Vitamin B12 and or folate deficiency