Amy is a 3 year old girl brought to the GP by her mother. Her health visitors has discussed her previously in the surgery and has been trying to persuade Amys mother to attend. she is worried about Amys behavior although Amys mother laughs it off and thinks it's just a phase she's going through. Amy has a longstanding habit of licking and chewing objects such as toys, picking plaster and paints off walls and eating it. This will happen anywhere, including paint from shop Windows. As a toddler she also used to eat mud and stone but this has recently reduced. Her mother reports some complaints of tummy ache and constipation but otherwise not worried about her daughter.
On ecmxamibation she's anemic and looks thin but there are no other signs.
a) What is the diagnosis?
b) What further information should you gather?
c) What complications have arise?
d) What is the management