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Is it safe to use asthma inhaler ou asthma medicine during pregnancy? Is it safe for mom and for baby! 1 Reply

It's very important to keep asthma under control during pregnancy because severe asthma attacks can be dangerous to the pregnancy.A commonly prescribed bronchodilatatato;salbutamol (ventolin) can be…Continue

Tags: pregnancy, asthma

Started by Dr Jalel BEN GHOZZIA. Last reply by Donna D'Alessandro May 8.

pediatric case 6 Replies

hello,young female 4y old with urinary tract  infection and her urine analysis show bus cells 100/HPFand her blood picture show :RBCes count:5.2 10^6/cmm , HB 9.4 g/dl ,HB% 58.8 % , haematocrete…Continue

Started by azza helal. Last reply by Donna D'Alessandro Mar 3.

brain death lecture 3 Replies

please add this lecture in the lectures section.Continue

Started by Ahmed A. Elkhirshy. Last reply by Ahmed A. Elkhirshy Feb 4.

 

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Pediatric Commons Curators left a comment for Jorge E>Montes
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Donna D'Alessandro posted a blog post

What Types of Patients Can Be Referred for Palliative Care Services?

StoryA 26-year-old male came to the inpatient unit for increasing respiratory distress. He had cystic fibrosis and over the past year had had frequent hospitalizations for respiratory distress, pneumonia and "tune-ups" and his pulmonary function was diminishing rapidly over the time. Over the past week he had been more tired and somnolent. He had an increased oxygen requirement with increased coughing and secretions. The coughing and oxygen make it difficult for him to communicate and he had told his mother that he wanted to come to the hospital now. He was well known to the hospital staff and his parents were always very attentive to him during his hospitalizations. The social history was that he was an only child. His mother was a homemaker and his father was a businessman.The pertinent physical exam showed a very thin male in moderate respiratory distress. He was breathing deeply 24 times/minute with frequent coughing. His saturation was only 88% on 2 liters of oxygen/minute by…See More
19 hours ago
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Pediatric Commons Curators left a comment for Dr. Md. Mahbub Hossain Sardar
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Nov 18
Syeda Nazish Azim is now a member of Pediatric Commons
Nov 18
Donna D'Alessandro posted a blog post

"I'm Just In the Band"

StoryA 13-year-old female came to clinic for her health supervision visit. She had no concerns except for a dry red rash on her chin. She said that she had it off and on but it had worsened in the past two weeks. She denied any new soaps, lotions, or cosmetics. The past medical history was non-contributory. The social history showed that she was doing well academically in 8th grade. She played the clarinet and was in a church-organization that performed community service.The pertinent physical exam revealed a healthy female with growth parameters in the 10-25%. Her skin examination showed some dry irritated skin about 2 cm wide that extended linerally from her lip to her chin. It did not appear infected. Her left index finger and right thumb also showed some irritated skin. She denied any changes in skin sensation or pain.The diagnosis of a healthy female with dermatitis was made. The physician asked more questions about her skin and the girl offered that she had been practicing her…See More
Nov 17
Donna D'Alessandro posted a blog post

"Which is More Accurate, the Hemoglobin or the Hematocrit?"

StoryPatient Presentation A 14-month-old female came to clinic for her health supervision visit and was found to be healthy and developmentally appropriate. She was drinking 16 ounces of whole milk/day and eating table foods. The family received assistance through federal food programs. Her screening laboratories showed a normal lead test, and a hemoglobin of 11.0 g/dl and hematocrit of 31%. The pediatrician decided to treat her with iron because of the low hematocrit despite the normal hemoglobin because of her social risk factors for iron deficiency anemia. The patient was seen back 6 weeks later by another pediatrician in the practice who obtained additional laboratories including a complete blood count and iron studies which were consistent with iron deficiency anemia. A discussion about when to begin empiric iron therapy and how much iron to treat with occurred with both pediatricians discussing the merits of different options. During the conversation, one asked the other,…See More
Nov 10
Donna D'Alessandro posted a blog post

Is This Bursitis?

StoryA 16-year-old male came to clinic as 5 hours earlier while in school he noted that his right elbow was swollen. He watched it for about an hour and thought that it was enlarging so he saw the school nurse. The nurse was concerned and called his parents who took him to a local urgent care center. Over that time, the elbow continued to swell. The family was not happy with the care provided at the urgent care center so they brought him to the pediatric clinic. He denied any trauma, pain or decreased motion. He denied any recent insect bites, minor scratches or pruritis. The past medical history showed a healthy male. The review of systems was negative for fever, rash, sore throat, cough, upper respiratory tract infection symptoms, genitourinary symptoms, emesis, diarrhea, nausea or headache.The pertinent physical exam showed a healthy male with normal vital signs and he was afebrile. His elbow was markedly swollen posteriorly with no external landmarks visible. There was a 5 cm…See More
Nov 3
Donna D'Alessandro posted a blog post

What Immunizations Can Pregnant and Postpartum Women Receive?

StoryPatient Presentation A 4-day-old male came to clinic for his followup newborn appointment. He was a full-term male, born by vaginal delivery without complications. His mother was a 26 year old female, G1P1, who had no prenatal or natal complications and received obstetrical care throughout her pregnancy. He was breastfeeding every 2-3 hours for 10-15 minutes and was having many wet diapers. He was stooling 4-5 times/day and the stools were starting to transition. His mother had received Tdap during pregnancy and his father received it in the nursery, but influenza vaccine was not available at the hospital. The pertinent physical exam revealed a vigorous infant, with a decrease in weight of 6% and other vital signs were normal. He was mildly jaundiced on the face but not the body. His examination was otherwise normal.The diagnosis of a healthy male infant was made. The pediatrician's office in a multispeciality group practice had just begun vaccinating patients for seasonal…See More
Oct 27
Pediatric Commons Curators left a comment for Jim Wischmeier
"Hello Jim and Welcome to the Pediatric Commons Team! First look at the Welcome page. Then please enter an interesting case into your Learning Portfolio and upload an interesting image to your Photo section to get started. Also please upload a…"
Oct 24
Jim Wischmeier is now a member of Pediatric Commons
Oct 24
Pediatric Commons Curators left a comment for Vicente Winston Billena III
"Hello Winston and Welcome to the Pediatric Commons Team! First look at the Welcome page. Then please enter an interesting case into your Learning Portfolio and upload an interesting image to your Photo section to get started. Also please upload a…"
Oct 22
Pediatric Commons Curators left a comment for Vicente Winston Billena III
Oct 22
Vicente Winston Billena III is now a member of Pediatric Commons
Oct 22
Donna D'Alessandro posted a blog post

Is Enterovirus D68 A New Virus?

StoryA 3-year-old male came to clinic with fever, runny nose and cough for 36 hours. His parents had treated him with ibuprofen which helped but they felt he was now wheezing. He had no history of asthma or other respiratory problems. He did attend day care and there had been several other children with similar illnesses, and enteroviruses were circulating in the community. He was drinking and urinating well. The past medical history showed upper respiratory tract infections and some otitis media. The family history was negative for asthma, but there was an elderly uncle with chronic obstructive pulmonary disease. The review of systems was negative including for rashes.The pertinent physical exam showed he was mildly ill-appearing with a fever of 38.2°C., respiratory rate of 28/minute, pulse of 104 beats/minute and growth parameters that were 75-90% for age. HEENT showed clear rhinorrhea, mildly erythematous pharynx, and clear tympanic membranes. His lungs had some transmitted upper…See More
Oct 20
Donna D'Alessandro posted a blog post

What Factors Decide Urolithiasis Treatment?

StoryA pediatrician saw two patients with urolithiasis over two weeks that had been managed differently and she wondered what were the factors that had been used for their treatment decisions. The first was a 17-year-old female who was traveling by car and had exquisite abdominal and flank pain that became worse and caused the family to seek care at the nearest hospital along the road. The diagnosis was made by computed tomographic scan and the patient was taken to the operating room for removal of the stone "just above my bladder" and placement of a stent. Her medical records showed that it was a 7 mm calcium oxalate stone causing mild hydronephrosis just above the ureterovesical junction. The stent was removed 10 days later and she had been doing well since. The second patient was an 8-year-old male who had sudden onset of abdominal and flank pain and was seen in the local emergency room. A 3 mm stone located above the ureterovesical junction that was not causing hydronephrosis was…See More
Oct 13
 
 
 

Learning Portfolio Posts

What Types of Patients Can Be Referred for Palliative Care Services?

Posted by Donna D'Alessandro on November 24, 2014 at 12:30am 0 Comments

Story

A 26-year-old male came to the inpatient unit for increasing respiratory distress. He had cystic fibrosis and over the past year had had frequent hospitalizations for respiratory distress, pneumonia and "tune-ups" and his pulmonary function was diminishing rapidly over the time. Over the past week he had been more tired and somnolent. He had an increased oxygen requirement with increased coughing and secretions. The coughing and oxygen make it difficult for him to…

Continue

"I'm Just In the Band"

Posted by Donna D'Alessandro on November 17, 2014 at 12:30pm 0 Comments

Story

A 13-year-old female came to clinic for her health supervision visit. She had no concerns except for a dry red rash on her chin. She said that she had it off and on but it had worsened in the past two weeks. She denied any new soaps, lotions, or cosmetics. The past medical history was non-contributory. The social history showed that she was doing well academically in 8th grade. She played the clarinet and was in a church-organization that performed…

Continue

"Which is More Accurate, the Hemoglobin or the Hematocrit?"

Posted by Donna D'Alessandro on November 10, 2014 at 12:30am 0 Comments

Story

Patient Presentation

A 14-month-old female came to clinic for her health supervision visit and was found to be healthy and developmentally appropriate. She was drinking 16 ounces of whole milk/day and eating table foods. The family received assistance through federal food programs. Her screening laboratories showed a normal lead test, and a hemoglobin of 11.0 g/dl and hematocrit of 31%. The pediatrician decided to treat her with iron because of the low…

Continue

Is This Bursitis?

Posted by Donna D'Alessandro on November 3, 2014 at 12:30am 0 Comments

Story

A 16-year-old male came to clinic as 5 hours earlier while in school he noted that his right elbow was swollen. He watched it for about an hour and thought that it was enlarging so he saw the school nurse. The nurse was concerned and called his parents who took him to a local urgent care center. Over that time, the elbow continued to swell. The family was not happy with the care provided at the urgent care center so they brought him to the pediatric clinic. He…

Continue

What Immunizations Can Pregnant and Postpartum Women Receive?

Posted by Donna D'Alessandro on October 27, 2014 at 12:30am 0 Comments

Story

Patient Presentation

A 4-day-old male came to clinic for his followup newborn appointment. He was a full-term male, born by vaginal delivery without complications. His mother was a 26 year old female, G1P1, who had no prenatal or natal complications and received obstetrical care throughout her pregnancy. He was breastfeeding every 2-3 hours for 10-15 minutes and was having many wet diapers. He was stooling 4-5 times/day and the stools were starting to…

Continue

Is Enterovirus D68 A New Virus?

Posted by Donna D'Alessandro on October 20, 2014 at 12:30am 0 Comments

Story

A 3-year-old male came to clinic with fever, runny nose and cough for 36 hours. His parents had treated him with ibuprofen which helped but they felt he was now wheezing. He had no history of asthma or other respiratory problems. He did attend day care and there had been several other children with similar illnesses, and enteroviruses were circulating in the community. He was drinking and urinating well. The past medical history showed upper respiratory…

Continue

What Factors Decide Urolithiasis Treatment?

Posted by Donna D'Alessandro on October 13, 2014 at 12:30am 0 Comments

Story

A pediatrician saw two patients with urolithiasis over two weeks that had been managed differently and she wondered what were the factors that had been used for their treatment decisions. The first was a 17-year-old female who was traveling by car and had exquisite abdominal and flank pain that became worse and caused the family to seek care at the nearest hospital along the road. The diagnosis was made by computed tomographic scan and the patient was taken to the…

Continue

What Are Legal Issues that Affect Health?

Posted by Donna D'Alessandro on October 6, 2014 at 12:30am 0 Comments

Story

An 8-year-old Hispanic male came to clinic for his well child care. His mother had no concerns except that he was not doing as well in second grade as she had wanted. He had received English-language learner (ELL) services during kindergarten and first grade, but they were stopped when he entered 2nd grade. He had always struggled with reading she said. The teacher said that he didn't qualify for ELL services anymore and there were no other additional services for…

Continue

What Are the Essential Amino Acids and How Much Protein Do I Need?

Posted by Donna D'Alessandro on September 29, 2014 at 12:30am 0 Comments

Story

A 14-year-old male came to clinic for his health supervision visit. He was a runner and had become more interested in eating healthier to improve his running. "I'm drinking more milk and eating more vegetables lately," he said. "I'm thinking about eating vegetarian, but I'm not sure that I can get enough protein. I don't like seeds, nuts, or tofu, so I'm not sure that I can do it," he explained. The past medical history showed no athletic injuries. The…

Continue

What Types of Abdominal Wall Defects Are There?

Posted by Donna D'Alessandro on September 22, 2014 at 12:30am 0 Comments

Story

A 5-year-old female came to clinic for her health supervision visit. She was well but the father wanted to address "her other belly button." The parent said that sometimes there was bulge above her umbilicus but it was not consistent. She denied any pain or problems because of it. The past medical history revealed a well child who had a previously diagnosed umbilical hernia.

The pertinent physical exam showed a well child with normal vital signs…

Continue

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