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Thomas 5 year old boy, Northam (FHx
Rural background
recent financial…
Thomas 5 year old boy, Northam
PmHx:
- Uncomplicated birth
- reached all developmental milestones at usual ages
- uncomplicated untreated otitis media 9mo ago
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FHx
- Rural background
- recent financial issues
- Mother, Yvonne D. (PT cleaner at school) brought him in
- Father recently started work as aerial spraying contractor after 3mo UE
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Mother has concerns about the impact of doing chemotherapy in Perth on Thomas & rest of family - looking into other options
SHx
- 1st year of school
- progressing well
- happy & alert demeanor
- plays outdoors with friends
Pc
- Several unexplained nose bleeds
- unexplained bleeding from gums
- several bruises to chest & upper arms
Examination:
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Slight pallor, but nails pink
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Normal chest auscultation; no palpable spleen, liver nor lymph nodes, and normal abdomen palpation
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Blood test results
Blood film shows:
- normal erythrocytes
- normal neutrophil
- normal lymphocyte but 2 lymphoblasts present
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Blood count:
- mild normochromic anaemia - mildly elevated total white cells
- severely reduced platelet count (50,000/mL)
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