You are a GP evaluating a 12 year old boy with persistent nose bleeds. He otherwise feels well with no past medical history. He is on no medications. FBC shows:

• Hb 140g/l (130-180)
• MCV 90fl (82-98)
• WCC 8.5×10⁹/l (4-11)
• Neutrophils 5.7×10⁹/l (1.7-7.5)
• Lymphocytes 2.3×10⁹/l  (1.5-4.5)
• Platelets 74×10⁹/l (150-450)

Questions

• How do you investigate this further?

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