A 2-year-old child presents with painful swelling on the dorsal surfaces of the hands, feet, fingers, and toes. Blood pressure 110/70 mmHg, Heart rate 100/min, Respiratory rate 22/... A 2-year-old child presents with painful swelling on the dorsal surfaces of the hands, feet, fingers, and toes. Blood pressure 110/70 mmHg, Heart rate 100/min, Respiratory rate 22/min, Temperature 38.9° C. Test Result: Hb 77 (Normal Values: 112-165 g/L), Reticulocyte 3.9 (Normal Values: 0.2-1.2%), Blood smear: Several elongated and crescent shaped red blood cells. Which of the following is the most appropriate on-going care? A. Vitamin B12 B. Corticosteroids C. Iron supplement D. Penicillin and immunization
Understand the Problem
The question describes a 2-year-old child presenting with symptoms suggestive of sickle cell disease (painful swelling, abnormal blood results including crescent shaped red blood cells). We need to determine the most appropriate ongoing care based on the provided information.
Answer
D. Penicillin and immunization
The most appropriate ongoing care is D. Penicillin and immunization.
Answer for screen readers
The most appropriate ongoing care is D. Penicillin and immunization.
More Information
The patient's symptoms and blood smear results strongly suggest sickle cell disease. Children with sickle cell disease are at high risk for infections, especially from encapsulated organisms like Streptococcus pneumoniae. Penicillin prophylaxis and ensuring appropriate immunizations are crucial for preventing these infections and reducing morbidity and mortality.
Tips
A common mistake is to focus solely on the anemia (low Hb) and consider iron supplementation. However, the sickle-shaped cells on the blood smear are the key to the correct diagnosis and management.
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