Paediatric Anemia

A 3-month-old infant presents with pallor. His FBC shows pancytopenia. Bone marrow examination reveals decreased cellularity with all cell lines affected. Which of the following components of hematopoiesis would be MOST crucial to analyze this patient?

• Hemoglobin synthesis pathway

• Hematopoietic stem cell niche

• Iron transport mechanisms

• Erythropoeitin production

A medical student is analyzing the regulation of erythropoeisis. When comparing a term neonate's blood sample with that of a 7-month-old infant, which of the following changes would best demonstrate normal physiological adaptation?

• Increased HbF to HbA ratio

• Decreased total hemoglobin with decreased reticulocytes

• Increased erythropoietin with normal Hb

• Decreased hemoglobin with increased reticulocytes

A 2-year-old girl came for her routine check up, noted her growth is failing centile. Dietary history revealed that the child is picky eater and still on full breastfeeding. Otherwise, physical examination does not reveal any other abnormalities. What is the likely provisional diagnosis.

• Iron deficiency anemia

• Thalassemia

• Vitamin B12 deficiency

• G6PD deficiency

A 2-year-old boy develops acute hemolysis after eating fava beans. His father had a similar episode in childhooc. In analyzing the pathophysiology, which sequence of events BEST explains the acute hemolysis?

• Oxidative stress > reduced glutathione depletion > membrane damage

• Membrane defect > spherocyte formation > splenic destruction

• Autoantibody formation > complement activation > cell lysis

• Direct toxin effect > membrane distruption > cell lysis

Which combination of findings would best represent B-thalassemia major?

• HbA 95%, HbA2 3.5%, HbF 1.5%

• HbA 20%, HbA2 4%, HbF 76%

• HbA 0%, HbA2 2%, HbF 98%

• HbA 85%, HbA2 2%, HbF 13%