A careful exposure history does more work here than broad allergy testing. The episode is strongest on two common mistakes: treating skin prick or serum allergen-specific IgE as proof of food allergy, and undercalling anaphylaxis when respiratory or cardiovascular features are already present.

Recurrent abdominal pain looks different when dark urine, neuropathy or blistering skin are in the history. Open this for a clear reminder that urinary porphobilinogen matters during an acute attack, while photosensitive blistering points instead towards cutaneous porphyria and sun protection.

Jaundice or anaemia after infection, broad beans, or nitrofurantoin should slow the consultation down. The useful twist is that a G6PD assay can look normal during acute haemolysis, so this is the best place to start if you want one practice-changing point today.

The pitfall is to call every infective dip in haemoglobin a haemolytic crisis. This episode is a strong refresher on jaundice, splenomegaly, gallstones, raised MCHC and the parvovirus B19 aplastic crisis that changes the interpretation of sudden deterioration.

The clue is microcytic anaemia that comes with jaundice, splenomegaly, or poor growth rather than sitting alone. This is a strong listen for anyone who wants a quick route from suspicion to haemoglobin electrophoresis, ferritin monitoring, and severity-based thinking.

Do not reassure yourself that chest pain or breathlessness in sickle cell disease is just another painful crisis. This is a strong refresher on acute chest syndrome, splenic sequestration, priapism, infection risk, and the practical checks that should happen every time a patient arrives in pain.

Isolated thrombocytopenia with bruising, petechiae, purpura or mucosal bleeding after a recent viral illness should trigger an early full blood count. Escalation depends on bleeding severity rather than the label alone, and platelet transfusion is reserved for life-threatening bleeding because correction is short lived.

Childhood leukaemia often presents as marrow failure rather than a single dramatic symptom. Fatigue, infections and bruising or petechiae together should trigger urgent blood testing, while unexplained petechiae or hepatosplenomegaly need immediate specialist assessment.

Iron deficiency anaemia in children is often hiding in the diet history. Microcytosis, low ferritin, pica and poor growth should prompt questions about excess cow’s milk, selective eating and menstruation, with treatment focused on oral iron plus correcting the cause.

Paediatric anaemia work-up starts with pattern recognition, not iron tablets alone. Reticulocyte count is the pivot: a raised count suggests haemolysis or blood loss, while a low count points towards reduced production and should trigger more targeted investigation.