Paeds Cases · haematology-oncology-and-transfusion
Iron deficiency anaemia — OSCE
OSCE communication and clinical reasoning station for the parents of a 20-month-old boy newly diagnosed with iron deficiency anaemia from excessive cow's milk intake, covering the diagnosis, the role of cow's milk, the iron regimen and expected response, the dietary changes, and the safety-net for the refractory case.
On this page
Study tools
Target exams
Candidate brief
You are the paediatric registrar. The patient is a 20-month-old boy who presented with pallor and irritability. His haemoglobin is 74 g per litre with a mean cell volume of 65 fL and a ferritin of 4 micrograms per litre, confirming iron deficiency anaemia. He drinks about 900 mL of cow's milk per day and eats very little solid food. The consultant has asked you to explain to his parents what the diagnosis means, why the cow's milk is the main problem, what the iron medicine and the daily changes involve, how they will know it is working, and how to keep him safe. The parents are worried that he is seriously ill and confused about why milk, which they thought was healthy, is causing the problem. Explain clearly, check their understanding, and agree a plan. [4][5]
References5ShowHide
- [1]Lopez A; Cacoub P; Macdougall IC; Peyrin-Biroulet L Iron deficiency anaemia. Lancet, 2016.PMID 26314490
- [3]Mattiello V; Schmugge M; Hengartner H; von der Weid N; Renella R; SPOG Pediatric Hematology Working Group Diagnosis and management of iron deficiency in children with or without anemia: consensus recommendations of the SPOG Pediatric Hematology Working Group. Eur J Pediatr, 2020.PMID 32020331
- [4]Leung AKC; Lam JM; Wong AHC; Hon KL; Li X Iron Deficiency Anemia: An Updated Review. Curr Pediatr Rev, 2024.PMID 37497686
- [5]Wang M Iron Deficiency and Other Types of Anemia in Infants and Children. Am Fam Physician, 2016.PMID 26926814
- [8]Stoffel NU; Cercamondi CI; Brittenham G; Zeder C; Geurts-Moespot AJ; Swinkels DW; Moretti D; Zimmermann MB Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. Lancet Haematol, 2017.PMID 29032957