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Elsa is an 11-month-old girl. Her parents have brought her to her pediatrician because they have noticed she seems lethargic and pale. Both parents have noticed that she appears bloated, doesn't want to eat as much as she has before, and is tired and "cranky all the time." They suspected she might be suffering from anemia, since she was being fed a low-iron formula, so they had switched to a high-iron formula. The change made no difference in her symptoms. The pediatrician notes that Elsa's belly appears swollen. Her vital signs show that her temperature is normal and her heart rate is on the low end of the normal range for her age. She has dropped from the 50th percentile in height and weight (at her last check-up) to the 10th percentile in both height and weight.
Blood test results:
Hemoglobin: 5 g/dl
RBC: 4.6x106 cells/ml
MCV: 65
WBC 15,000 cells/ml
Platelet count: 250,000
Which of Elsa's symptoms is NOT typical of anemia in infants?
A) Paleness
B) Tiredness
C) Slow heart rate
D) Loss of appetite
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