It’s been a long day. The will to debate has been beaten out of you. You would probably accept seeing a 8 year old boy with amenorrhea right now.
You are reassured the patient is on fluids. When you get to the ward, on the 13th floor which required using three different lifts due to the architectural planning wonderland that is the NHS hospital, you see his blood results:
| Haemoglobin | 76 (130 – 180) g/l |
| MCV | 82 (80 – 97) fl |
| Platelets | 170 (150-400) x 10^9/l |
| Reticulocytes | 3.2 (0.2-2.0) % |
| INR | 4.3 (0.9-1.2) |
| Urea | 34.1 (2.5-7.8) mmol/L |
| Creatinine | 67 (59-104) μmol/ L |
| Sodium | 135 (133-145) mmol/L |
| Potassium | 4.1 (3.5-5.4) mmol/L |
| Albumin | 31 (35-50) g/l |
His blood pressure is 113/77 mmHg.
“Hmm,” you grunt. What next?
Urine dipstick to check for blood and protein