Lab Two A: Acute Leukemias

Case 1


Case Presentation

A 6-year-old boy is brought to the pediatrician by his mother. He has not been himself for the past month. His teachers have become concerned about his ability to concentrate. He has reverted to napping after school rather than playing. He has complained of headaches for the past few weeks. The child has previously been healthy. His development has been normal and his immunizations are up to date. His lungs are clear. His heart has no murmur. His abdomen is soft. He has no edema. He has a few ecchymoses on his knees.

On Physical exam...

BP 100/56 mmHg
Pulse 98 /minute
Temp 98.4 F
Resp 25 /minute

CBC:

  Patient Normal Male
WBC 20.2x103 3.5 – 10.6 x103 /μL
RBC 2.07x106 4.27 – 5.69 x106 /μL
HGB 5.4 13.3 – 17.1 g/dL
HCT 17 38.9 – 48.0 %
MCV 82 81.0 – 98.0 fL
Platelets 32x103 150 - 450 x103 /μL

Question #1: What should you do next?