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  #1  
Old 03-15-2013
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Pediatrics Likely complication of this infant

A 4 month old infant is brought to your clinic by his mom complaining of irritability and jaundice. Due to their poor socio-economic status they live in a pre-1950s apartment just around the city. On further questioning the mother reveals that the infant is exclusively on breast milk and she can't figure out what is causing the problem. You run some blood tests and following results come.
Hb: 9 g/dL
MCV: 70
MCH: 28
Reticulocytes: 7%
Which of the following is the most common complication if treatment is not initiated?

A. Worsening of pre-existing heart failure
B. Neuro-developmental delay
C. Iron overload
D. High output heart failure
E. Impaired muscular performance
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  #2  
Old 03-16-2013
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B. neuro-developmental delay
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  #3  
Old 03-16-2013
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Quote:
Originally Posted by ohbunnie View Post
A 4 month old infant is brought to your clinic by his mom complaining of irritability and jaundice. Due to their poor socio-economic status they live in a pre-1950s apartment just around the city. On further questioning the mother reveals that the infant is exclusively on breast milk and she can't figure out what is causing the problem. You run some blood tests and following results come.
Hb: 9 g/dL
MCV: 70
MCH: 28
Reticulocytes: 7%
Which of the following is the most common complication if treatment is not initiated?

A. Worsening of pre-existing heart failure
B. Neuro-developmental delay
C. Iron overload
D. High output heart failure
E. Impaired muscular performance
B. Neuro-developmental delay.

Lead poisoning
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  #4  
Old 03-16-2013
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Default C. Iron overload

C. Iron overload
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  #5  
Old 03-17-2013
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Quote:
Originally Posted by fadi551 View Post
C. Iron overload
From what?
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  #6  
Old 03-17-2013
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Quote:
Originally Posted by OzoneZone234 View Post
From what?

Reticulocytes is elevated = hemolytic anemia = iron overload

In lead poisoning = bone marrow depression = low RCT
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Old 03-17-2013
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d)high out put heart failure
yes it is hemolytic anemia(retics count) but the question said if not treated
iron over load occurs if he is treated with repeated transfusions.
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Old 03-17-2013
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Quote:
Originally Posted by sonami View Post
d)high out put heart failure
yes it is hemolytic anemia(retics count) but the question said if not treated
iron over load occurs if he is treated with repeated transfusions.
Hemolysis will cause reticulocytosis for sure but will it also cause low MCV? This is a weird question.

OP, what is your answer?
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  #9  
Old 03-17-2013
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yes in general high retics gives normal or slightly high MCV.
I think the only possible exaplanation is hemoglobin H.

Hhttp://emedicine.medscape.com/article/955496-workup#aw2aab6b5b2
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  #10  
Old 03-19-2013
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B. neuro-developmental delay
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