Anaemia: diagnostic approach — viva

Opening

Examiner: The haemoglobin is 82 g/L. How do you start? ^[1]

Candidate: First I confirm the child is stable, because severe anaemia can present with cardiac compromise. Then I classify the count rather than jump to a diagnosis. I ask two questions: what is the mean corpuscular volume, and is the reticulocyte count appropriate? Those two answers, plus a peripheral film, organise almost every case before any second-line test. ^{[1] [3]}