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Hematology

What is the most common cause of anemia in children less than 24 months old?

A. Anemia of prematurity

B. Thalassemia

C. Iron-deficiency anemia

D. Sickle cell trait

Answer: C

The most common cause of anemia in children less than 24 months old is iron-deficiency anemia, with the highest risk between 9 and 24 months. While thalassemia, sickle cell trait, and anemia of prematurity may lead to anemia in young children, they are not the most common cause in this age group.

References: Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-1843. Pubmed ID: 25946282.

Baker RD, Greer FR; Committee on Nutrition American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5):1040-1050. Pubmed ID: 20923825.

Which of the following situations increases risk of iron-deficiency anemia in children?

A. Introduction of cow's milk after 12 months old

B. Breastfeeding with introduction of iron-fortified cereal at 4 to 6 months

C. Premature birth

D. Feeding with iron-fortified formula

Answer: C

Healthy infants are most likely to develop iron-deficiency anemia between 9 and 24 months, a time of increased growth and potentially decreased iron intake as solid food is introduced. Special populations that are at further increased risk for developing iron-deficiency anemia include premature infants who are 2 months or older (they may have lower iron stores than full-term infants), children who drink cow's milk before 12 months (which can interfere with iron absorption and may replace more iron-rich food in the diet), breastfed infants who do not get iron-fortified foods after 4 to 6 months, and infants given formula without iron.

References: Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-1843. Pubmed ID: 25946282.

Baker RD, Greer FR; Committee on Nutrition American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5):1040-1050. Pubmed ID: 20923825.

If a pediatric patient does not respond appropriately to iron supplementation despite compliance to therapy and appropriate dietary changes, what is the next step in diagnosis?

A. Referral to hematology

B. Obtain a hemoglobin electrophoresis

C. Colonoscopy ...

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