Knowledge Check: Pediatrics

In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content. Apply at least one primary citation supported by its reference to reflect source of information supporting your point(s). Primary references have been published in last 5 years, are not patient ed or news articles. Done in APA format. Considering the extensive, advanced information included in textbook readings, please use it to support your points. 

Reference McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby Elsevier. St. Louis.


Citation (McCance, 2019) 

Possible topics covered in this Knowledge Check include:

  • Growth and development
  • Normal growth patterns
  • Scoliosis (ortho)
  • Kawasaki
  • Alterations in children
  • Congenital (heart syndrome)
  • PDAs
  • Sudden Infant Death Syndrome (SIDS)
  • Asthma
  • Lead poisoning and effects on neurological functioning
  • Sickle cell
  • Hemophilia


Scenario 1: Acute Lymphoblastic Leukemia (ALL)

An 11-year-old boy is brought to the clinic by his parents who states that the boy has not been eating and listless. The mother also notes that he has been easily bruising without trauma as he says he is too tired to go out and play. He says his bones hurt sometimes. Mother states the child has had intermittent fevers that respond to acetaminophen. 

Maternal history negative for pre, intra, or post-partum problems. 

PMH: Negative. Easily reached developmental milestones. 

PE: reveals a thin, very pale child who has bruises on his arms and legs in no particular pattern. 

LABS: CBC revealed Hemoglobin of 6.9/dl, hematocrit of 19%, and platelet count of 80,000/mm3. The CMP demonstrated a blood urea nitrogen (BUN) of 34m g/dl and creatinine of 2.9 mg/dl. 

DIAGNOSIS: acute leukemia and renal failure and immediately refers the patient to the Emergency Room where a pediatric hematologist has been consulted and is waiting for the boy and his parents. 

CONFIRMED DX: acute lymphoblastic leukemia (ALL) was made after extensive testing.  


  1. Explain what ALL is?     
  2.  Why does ARF occur in some patients with ALL? 


Scenario 2: Sickle Cell Disease (SCD)

A 15-year-old male with known sickle cell disease (SCD) present to the ER in sickle cell crisis. The patient is crying with pain and states this is the third acute episode he has had in the last 10-months. Both parents are present and appear very anxious and teary eyed. A diagnosis of acute sickle cell crisis was made. 


  1. Explain the pathophysiology of acute SCD crisis. Why is pain the predominate feature of acute crises?  


  1. Discuss the genetic basis for SCD.

Scenario 3: Hemophilia

8-month infant is brought into the office due to a swollen right knee and excessive bruising. The parents have noticed bruising about a month ago but thought the bruising was due to the attempts to crawl. They became concerned when the baby woke up with a swollen knee. Infant up to date on all immunizations, has not had any medical problems since birth and has met all developmental milestones. 

FH: negative for any history of bleeding disorders or other major genetic diseases. 

PE: within normal limits except for obvious bruising on the extremities and right knee. Knee is swollen but no warmth appreciated. Range of motion of knee limited due to the swelling.

DIAGNOSIS: hemophilia A.    



1. What is the pathophysiology of Hemophilia