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How would you evaluate and manage a pediatric patient who has a painful swelling of the hands and feet, fatigue, or fussiness? Which diagnostic studies would you recommend forthis patient and why?
significant for scleral icterus, splenomegaly and a flow murmur. She has had similar but milder, self-resolving episodes in the past for which she was not seen by a doctor. As the patient is an adoptee from Hati without available familyhistory. Laboratory results included normocytic anemia, elevated reticulocyte count, elevated WBC, elevated ESR, HGBSS, sickle shaped cells, splenomegaly, and dactylitis. Three