Approach to melena and hematemesis (pediatrics) Quiz: Ace Your Exams
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A 5-year-old boy presents with his parents to the pediatrician for evaluation of dark-colored stools for the past two weeks. The patient has not had constipation, diarrhea, abdominal pain, pain with defecation or mucous in stools. Family history is notable for the biological father who has vascular malformations. Temperature is 37 °C (98.6 °F), pulse is 98/min, respirations are 20/min, blood pressure is 100/62 mm Hg, and oxygen saturation is 96% on room air. On examination, the child appears pale with several dilated blood vessels visible on the cheeks bilaterally. Abdominal examination is normal. No hemorrhoids are visible on rectal examination. Fecal occult blood test is positive, and the rest of the laboratory results are shown below. Which of the following is likely associated with this patient’s underlying condition?
| Laboratory value | Results |
| Hemoglobin | 9 gm/dL |
| Mean corpuscular volume (MCV) | 72 fL |
| Mean corpuscular hemoglobin (MCH) | 23 pg |
| Red cell distribution width (RDW) | 51 fL |
| Platelets | 170,000 /μL |
| Prothrombin time (PT) | 11 |
| Activated partial thromboplastin time (PTT) | 28 |
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