top of page Skip to main content
Kornhauser Health Sciences Library

Michael Sutter: The Case

 

The Case

 

Setting: Pediatric Hematology clinic

HPI:

Michael is a 2-month-old male who is referred in consultation from his pediatrician’s office due to an abnormal hemoglobin result.

He is brought in by his mother and father and the history is provided by both his parents and the medical records. 

Discussion:

  1. Discuss the significance of this information.
  2. Generate a differential diagnosis.
  3. Prioritize your next steps/actions.
  4. Identify any learning issues.

 

His mother underwent routine prenatal care and only took prenatal vitamins and no other medications during pregnancy. There were no complications and Michael was delivered at full term. 

Michael experienced prolonged jaundice for the first 2 weeks of life which was treated with home UV light blankets and followed with serial lab draws. The jaundice was initially attributed to breastfeeding, but his parents were then told that it might be due to a blood problem. Michael was placed on prophylactic penicillin by his pediatrician.

He has since been growing and feeding well, without any unusual problems.

 

Discussion:

  1. Discuss the significance of new information.
  2. Revise your differential diagnosis.
  3. Prioritize your next steps/actions.
  4. Identify any learning issues.

 

PMH: As above

PSH: None

Medications: PCN

Allergies: NKDA

FH: He is their first baby, although Mom had a second trimester fetal demise the year prior to getting pregnant with Michael. Both parents are well and deny any known problems with blood in the family.

SH: Lives at home with mom and dad.  The parents are Jehovah’s Witness and have already stated they will not allow blood transfusions for Michael when they were told that he might have a blood disorder.

 

His physical exam is normal for his age with the exception of a palpable splenic edge 3 cm inferior to the costal margin and dullness with percussion in the left upper quadrant of the abdomen.

 

Discussion:

  1. Discuss the significance of new information.
  2. Revise your differential diagnosis.
  3. Prioritize your next steps/actions.
  4. Identify any learning issues.

MICHAEL’S NEWBORN SCREENING RESULT LETTER TO PRIMARY CARE PHYSICIAN

Discussion:

  1. Discuss the significance of new information.
  2. Revise your differential diagnosis.
  3. Prioritize your next steps/actions.
  4. Identify any learning issues.

Michael's Hemoglobin Electrophoresis at 2 Months of Age:

Clinical Librarian

Ansley Stuart's picture
Ansley Stuart
Contact:
Health Science Campus
Kornhauser Library, Rm 204
502-852-8534

Discover. Create. Succeed.