Question 168 · LEK · Iron deficiency anemia

A woman came to the GP with her one-year-old son because of a trivial viral infection of the upper respiratory tract. The doctor noticed paleness of the child. The boy had been fed non-modified cow milk since 6 months of age. He is unwilling to eat anything else than porridge with cow milk. The complete blood count shows: RBC 4 x 10⁶/µL, Hgb 9.0 g/dL, MCV 60 fL, RDW 18%, PLT 480 x 10³/µL, WBC 9 x 10³/µL. The child had never taken any medications. Indicate the correct management:

1. AA. the boy should be immediately referred to a hospital because of anemia and infection.
2. BB. megaloblastic anemia should be diagnosed, as a consequence of malnutrition; and oral preparations of folic acid and vitamin B₁₂should be prescribed.
3. CC. anemia related to the acute infection should be diagnosed; the infection should be cured and the full blood count should be repeated in 2 weeks.
4. DD. the child is well adapted to the anemia and no treatment is needed, only diet modification.
5. EE. iron-deficiency anemia should be diagnosed and an oral iron preparation should be prescribed as well as diet modification should be advised.