Child With Pallor.docx

Al-Qassimi PBL: The Child with Pallor Mohamed , 18 m old boy presents to Al Qassimi ER accompanied by his parents, the mother states that she thinks he child is not looking well and has some cough and rhinorrhea. There is history of mild fever of 38 C yesterday but he is afebrile today. On physical examination you notice that Mohamed is very pale, you listen to his chest and notice that he is tachycardic with HR 150, RR 20, there is soft systolic murmur on left sternal angle. On abdominal exam: the liver tip is palpable and spleen is palpable 3 cm below the costal margin. What is your diagnosis? What is your differential diagnosis? What tests will you order?

Among the investigations that you ordered , his Hb came back and is 4.5 What is your next step in management? What is your long term management?