🩸 Chapter 496 · Anemias

Nelson Textbook of Pediatrics 22nd Edition | Classification: microcytic, normocytic, macrocytic. Reticulocyte response, iron deficiency, thalassemia, anemia of chronic disease, hemoglobinopathies, and diagnostic algorithm based on MCV and reticulocyte count.

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📋 30 Assessment Scenarios — Anemias (FCPS / Board Style)

📇 High‑Yield Review Cards (Anemias)

🩺 Symptom‑Based Diagnostic Approach to Pediatric Anemia

Select a clinical presentation for diagnostic clues and classification.

📋 Stepwise Management & Diagnostic Algorithm (Nelson Ch 496)

📊 Algorithm: Approach to Anemia in Children
↓ Complete blood count + reticulocyte count + peripheral smear
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1. Is there anemia? Compare with age/gender norms (Table 496.1).
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2. Reticulocyte response? — Low/inadequate → decreased production; High/appropriate → hemolysis/bleeding.
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3. Classify by MCV:
  • Microcytic (MCV low): Iron deficiency (most common), thalassemia trait, anemia of chronic disease (can be normocytic), lead poisoning.
  • Normocytic (MCV normal): Acute blood loss, hemolysis (reticulocytosis), anemia of chronic disease, early iron deficiency, bone marrow failure.
  • Macrocytic (MCV high): B12/folate deficiency, reticulocytosis (reticulocytes are large), Diamond-Blackfan, liver disease, hypothyroidism.
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4. Targeted labs: Ferritin, iron/TIBC, Hb electrophoresis, hemoglobinopathy screen, vitamin B12/folate, bone marrow if suspected failure.

    ⚡ Reflex Prompts — Clinical Decisions in Anemias

    📖 Summary: Anemias — Classification & Key Points (Nelson Ch 496)