urgent case

Interesting case: 3 months, Nepali child, non consanguinous no adverse perinatal event, term, AFD,male presented with Progressive pallor 1 month No fever, jaundice, bleeding Exclusively breast fed (mother appropriate age, no pallor, on mixed diet) Examination: Stable vitals except tachycardia Pallor present No Icterus, Edema Liver 4 cm Spleen 6 cm Hb: 6.1 Platelets: 1.3 lacs TLC: 8000 Peripheral smear outside: anisocytosis with pred. normocytic to macrocytic RBCs with few macrovalocytes, slightly reduced platelets MCV of mother : 72 MCV of father : 78 Repeat Peripheral smear and DCT and B12 Level given. What are your differentials????

This 16 yr male boy came to our opd with severe pallor with splenohepatomegaly ( spleen 8cm bcm liver 4 cm bcm) with off and on fever negative for malaria and kala azar( K 39) what could be possible diagnosis and management pt is very poor we can't afford many investigation no prior transfusion history

A old age female with giddiness headache low grade pyrexia o/e no his of DM or hpt k/c/o hypothyroidism at constant appetite good cxr NAD USG NAD plz sugesst the diagnosis pt is stable nd not serious abt the count

19 yr female admitted with severe anemia hb 3.6 with severe menstrual bleeding., took 2 units of blood still hb not rising. recent history of admission in to another hospital and treated for malaria and hepatitis{ no records available}. no past history of such symptoms. examination revealed no specific findings. investigation reports attached. patient is now on blood transfusion. please suggest next line of management. reports showing pancytopenia, what may be the cause.

17 yr old female pt with h/o mild fever ,loss of appetite ,weakness ,heavy menstrual blood flow during menses. what is diagnosis and treatment. her blood investigations shown below.