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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.

Some diagnosis issues in severe malnutrition... 7 Replies

Hello! I was wondering if there is someone that can have any more ideas about this case.One year old female, with two older brothers diagnosed with cerebral palsy. The mother 36 years old, she did…Continue

Started by B.I.C.. Last reply by Donna D'Alessandro Oct 5, 2013.

 

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Donna D'Alessandro posted a blog post

What Treatment is Available for Lymphatic Malformations?

Story A full-term newborn female was born with a mass over her left lower back. The past medical history showed that she was born to a 22 year old G1P1 female with an uneventful pregnancy including a normal prenatal ultrasound. Delivery was uncomplicated except for the previously unrecognized mass. She had voided and stooled soon after birth. The family history was negative for neurological or genetic conditions. A maternal aunt had one spontaneous abortion early in pregnancy but had 2 other normal children.The pertinent physical exam showed a well appearing female with normal vital signs and growth parameters in the 25-50%. Ballard examination was consistent with a 39-40 week infant. The left lower back had a skin-covered sac measuring 15 x 7.5 cm that crossed the midline and displaced the gluteal cleft. There was a positive fluid wave. She was not bothered by the mass. She had a normal neurological examination and was moving all her extremities well and had normal strength and tone.…See More
7 hours ago
Donna D'Alessandro posted a blog post

How Does Pediatric Psoriasis Present?

StoryA 14-year-old male came to clinic with a history of a new scalp lesion that had been present for 2 weeks. He had recently seen his barber who noticed the lesion and thought that it was psoriasis. The patient had not tried any treatment. He denied any new soaps, lotions, shampoos, acne or other skin or makeup products. He denied pain, pruritus or burning. The past medical history showed that he had scalp and facial seborrhea as an infant that lasted until 15 months of age. He occasionally had a dry scalp and needed to use a general dandruff shampoo in the winter. He also has general xerosis that was controlled by emollients. The family history was positive for atopic dermatitis. The review of systems showed he was healthy with no fevers, weight loss, arthralgias or infections.The pertinent physical exam showed a healthy male with growth parameters in the 75-95%. The left parietal area had a 2.5 cm round lesion with thick yellow, greasy scale. There were no broken hairs or…See More
Apr 14
Pediatric Commons Curators left a comment for Abdullah S Al Sokkary
"Hello Abdullah 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…"
Apr 13
Abdullah S Al Sokkary is now a member of Pediatric Commons
Apr 13
Donna D'Alessandro posted a blog post

What Treatment is Available for Malaria?

Story A 17-year-old male came to the emergency room with a history of fever, chills, abdominal pain and headache for one day. The fever was to 102.5° and came and went. His headache was generalized and occurred mainly with the fever. His abdominal pain was more in the right upper quadrant with no radiation. He had nausea and therefore was not eating and was drinking less. The past medical and social history revealed he had recently come to the United State from eastern Africa. He said that he had had malaria several times in the past and the symptoms he was having were similar. The review of systems showed no dysuria with normal bowel and bladder function. He denied genital lesions or discharge, cough, rhinorrhea, or rashes.The pertinent physical exam showed a male in moderate distress who appeared mildly dehydrated. His abdominal examination showed a mildly tender liver that was 3-4 cm below his ribs. The rest of his examination was normal. The pertinent laboratory evaluation…See More
Apr 7
Pediatric Commons Curators left a comment for Ghulam Hussain
"Hello Ghulam 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…"
Apr 4
Ghulam Hussain is now a member of Pediatric Commons
Apr 4
Pediatric Commons Curators left a comment for Patricia Campbell
"Hello Patricia 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…"
Mar 31
Patricia Campbell is now a member of Pediatric Commons
Mar 31
Donna D'Alessandro posted a blog post

What Causes Ataxia?

Story A 33-month-old male was transferred to the inpatient unit with difficulty walking. One month ago he has Influenza A and one week ago he had diarrhea. Just before bed on the night before he seemed to walk a little funny but his maternal aunt thought that he was just tired. In the morning, the aunt saw that he was truly having problems walking and would fall backwards. He also seemed very fussy. He was taken to the local emergency room where his complete blood count, C-reactive protein, electrolytes, liver function tests, amylase and lipase, rapid strep test, urine toxicology screen and a head computed tomogram were negative. He was transferred to the regional children's hospital for further evaluation. The past medical history was positive for otitis medias and colds. He received appropriate health supervision visits and had been developing normally. The review of systems was negative for rash, fever, with no changes in level of consciousness, and bowel or bladder. He was now…See More
Mar 31
Pediatric Commons Curators left a comment for Faiza
"Hello Faiza 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. Please edit your Profile…"
Mar 26
Faiza is now a member of Pediatric Commons
Mar 26
Donna D'Alessandro posted a blog post

How do Gifted Children Present?

Story An 8-year-old male came to clinic for his health supervision visit. His parents had no specific health related questions but they had questions about his schooling. He had taken a national test for 3rd grade students in the fall and he had qualified for the school's gifted and talented program for the next year. The parents wanted to know if this was a good idea or "if this is just going to make him different from all the other kids." The past medical history noted that he had been an early talker and reader and would play with plastic building blocks for hours never following the package instructions and making his own creations. His parents said he wore them out by asking "why?" all the time. The family history showed that the parents had finished college doing so on a part-time basis because of financial constraints. The father also was taking distance-learning classes.The pertinent physical exam revealed a healthy male with normal growth and vital signs. The diagnosis of a…See More
Mar 24
Pediatric Commons Curators left a comment for fawaz
"Hello Fawaz 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. Please edit your Profile…"
Mar 12
fawaz is now a member of Pediatric Commons
Mar 12
Donna D'Alessandro posted a blog post

What Are Complications of Fractures?

Story A 14-year-old female came to clinic with right foot pain. The pain began approximately 5 months earlier after a fall on ice. Radiographs at that time were negative. Since that time, there usually was no pain, but pain would return and increase with more activity. Over the past 2 weeks, she began recreational league soccer practices and would have pain that initially occurred at the end of practice and now occurs when she begins running at the beginning of practice. She also complains that it is more painful when she is going up stairs or just at the end of a regular day. She denies any other trauma. The review of systems was negative.The pertinent physical exam revealed a healthy female with normal vital signs and growth parameters. Her extremity examination revealed pain over the proximal 5th metatarsal with palpation and also with supination and flexion of the foot. There was no erythema, bruising or edema. There was no other point tenderness and range of motion was normal in…See More
Mar 10
Donna D'Alessandro replied to azza helal's discussion 'pediatric case'
"I agree with the peripheral smear since it could give a lot of information about several possibilities including thalassemia. "
Mar 3
Donna D'Alessandro posted a blog post

What Are the Potential Side Effects of Iron Therapy?

Story A 15-month-old caucasian male came to clinic for his health supervision visit. He was developing and growing normally and his parents had no concerns. He was taking a mixed diet appropriate for his age with ~20 ounces of whole milk daily. The pertinent physical exam showed a healthy appearing male with growth parameters at the 75% and a normal examination. His screening laboratory evaluation showed a hemoglobin of 10.6 mg/dL.The new intern wasn't sure how to manage the diagnosis of anemia and asked about how much iron to prescribe. His medical record review noted a normal neonatal screening test and normal complete blood count at birth done because of a maternal fever. After discussion with her attending physician, they decided that this presumably was iron deficiency anemia, and they would treat with supplemental iron for 1 month and then followup with repeat labs including a reticulocyte count. The attending noted that in general, additional iron in a healthy infant doesn't…See More
Mar 3
Khaled Saifullah replied to azza helal's discussion 'pediatric case'
" if reticulocyte is more then normal range it could be thalassaemia. i think blood peripheral picture should be done. "
Mar 2
Donna D'Alessandro posted a blog post

How Long Before Gastroparesis Improves?

Story A 5-year-old male came to clinic with a history of ~ 7 days where he would have emesis. The episodes occurred at random times usually at least 1 or more hours after he had eaten. He denied nausea and was still hungry but he would not eat as much as usual. The emesis did not have blood or mucous and was of the food and beverages he had consumed. Some of the food was ingested 12-18 hours previously. The episodes occurred twice a day at least and at any time of the day. They usually did not occur over night, but parents said that one time he had an episode about 5 AM in the morning. They were not sure if he was already awakened and then had emesis or if he was awoken by it. He did have some abdominal pain especially around the time of the emesis but was able to play normally. They also noted that his abdomen seemed to be slightly larger. He had normal urination…See More
Feb 24
 
 
 

Learning Portfolio Posts

What Treatment is Available for Lymphatic Malformations?

Posted by Donna D'Alessandro on April 21, 2014 at 12:30am 0 Comments

Story

A full-term newborn female was born with a mass over her left lower back. The past medical history showed that she was born to a 22 year old G1P1 female with an uneventful pregnancy including a normal prenatal ultrasound. Delivery was uncomplicated except for the previously unrecognized mass. She had voided and stooled soon after birth. The family history was negative for neurological or genetic conditions. A maternal aunt had one spontaneous abortion…

Continue

How Does Pediatric Psoriasis Present?

Posted by Donna D'Alessandro on April 14, 2014 at 12:30am 0 Comments

Story

A 14-year-old male came to clinic with a history of a new scalp lesion that had been present for 2 weeks. He had recently seen his barber who noticed the lesion and thought that it was psoriasis. The patient had not tried any treatment. He denied any new soaps, lotions, shampoos, acne or other skin or makeup products. He denied pain, pruritus or burning. The past medical history showed that he had scalp and facial seborrhea as an infant that lasted until 15…

Continue

What Treatment is Available for Malaria?

Posted by Donna D'Alessandro on April 7, 2014 at 12:30am 0 Comments

Story

A 17-year-old male came to the emergency room with a history of fever, chills, abdominal pain and headache for one day. The fever was to 102.5° and came and went. His headache was generalized and occurred mainly with the fever. His abdominal pain was more in the right upper quadrant with no radiation. He had nausea and therefore was not eating and was drinking less. The past medical and social history revealed he had recently come to the United State from…

Continue

What Causes Ataxia?

Posted by Donna D'Alessandro on March 31, 2014 at 12:30am 0 Comments

Story

A 33-month-old male was transferred to the inpatient unit with difficulty walking. One month ago he has Influenza A and one week ago he had diarrhea. Just before bed on the night before he seemed to walk a little funny but his maternal aunt thought that he was just tired. In the morning, the aunt saw that he was truly having problems walking and would fall backwards. He also seemed very fussy. He was taken to the local emergency room where his complete blood count,…

Continue

How do Gifted Children Present?

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

Story

An 8-year-old male came to clinic for his health supervision visit. His parents had no specific health related questions but they had questions about his schooling. He had taken a national test for 3rd grade students in the fall and he had qualified for the school's gifted and talented program for the next year. The parents wanted to know if this was a good idea or "if this is just going to make him different from all the other kids." The past medical history noted…

Continue

What Are Complications of Fractures?

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

Story

A 14-year-old female came to clinic with right foot pain. The pain began approximately 5 months earlier after a fall on ice. Radiographs at that time were negative. Since that time, there usually was no pain, but pain would return and increase with more activity. Over the past 2 weeks, she began recreational league soccer practices and would have pain that initially occurred at the end of practice and now occurs when she begins running at the beginning of practice.…

Continue

What Are the Potential Side Effects of Iron Therapy?

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

Story

A 15-month-old caucasian male came to clinic for his health supervision visit. He was developing and growing normally and his parents had no concerns. He was taking a mixed diet appropriate for his age with ~20 ounces of whole milk daily. The pertinent physical exam showed a healthy appearing male with growth parameters at the 75% and a normal examination. His screening laboratory evaluation showed a hemoglobin of 10.6 mg/dL.

The new intern…

Continue

How Long Before Gastroparesis Improves?

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



Story


A 5-year-old male came to clinic with a history of ~ 7 days where he would have emesis. The episodes occurred at random times usually at least 1 or more hours after he had eaten. He denied nausea and was still hungry but he would not eat as much as usual. The emesis did not have blood or mucous and was of the food and beverages he had…

Continue

How Common is Hypersensitivity Cross-Reactivity with NSAIDs?

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

Story

A 5-year-old female came to clinic with a history of acute pharyngitis that was positive for Group A, β-hemolytic Streptococcus. When reviewing her medications and allergies, the resident noted that she was allergic to ibuprofen and her mother said that she had problems breathing and an urticarial rash twice after receiving ibuprofen that required her to go to the emergency room. The mother said that she used acetaminophen for pain and fever relief without any…

Continue

How Do You Treat Minor Pressure Ulcers?

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

Story

A 13-year-old female came to clinic with a complaint of recurrent wounds on her buttocks. These occurred over the past 3 months and had been getting worse during the summer. She and a friend had been training for a 7-day bike trip and had been increasing their mileage considerably over the past 2-3 weeks. She said that there had been several sore spots that changed in location over time but she now had two that were particularly painful and were not healing. She…

Continue

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