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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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Donna D'Alessandro posted a blog post

What Medicines Should Be Avoided with G6PD Deficiency?

Story A 3-day-old male came to clinic for a weight and bilirubin checkup. He was feeding well every 2-3 hours for 30 minutes. He was having several stools but they still had meconium. He would awaken but seemed sleeper for the past 24 hours per his mother, and she thought he looked more jaundiced. The past medical history showed that he was a 38 week gestation, appropriate-for-gestation-age, infant born vaginally to a G2P2 O+ female with no risk factors. He had an uneventful post-natal course and was discharged at 48 hours with a total bilirubin of 11.8 mg/dL. His neonatal screening test was normal. The family history was non-contributory other than both parents were originally from Italy and were now living in the United States. The review of systems was negative.The pertinent physical exam showed a sleepy-appearing male. His weight was 5% down from birth weight and was 2% down since discharge. He was jaundiced to at least his knees but otherwise appeared normal. His transcutaneous…See More
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Donna D'Alessandro posted a blog post

What is Gianotti-Crosti Syndrome?

Story A 4-year-old male came to clinic with a new rash and a low grade fever that had begun the night before. The mother said that the child had a recent sore throat but had been doing well until the last night when she noticed some papules on his upper legs. In the morning the rash had spread to his thighs and knees, buttocks and upper arms including the elbows. He had none on his face or trunk. The spots were becoming more extensive and were now red whereas the night before they were more flesh-colored or slightly pink. She denied new soaps, lotions, detergents or other similar products. He had not and was not taking any medication. There were several children in his daycare with colds. The past medical history was non-contributory.The pertinent physical exam showed a well-appearing male with normal vital signs including being afebrile and growth parameters in the 5-10%. He had a mildly erythematous throat, and some shotty cervical and inguinal adenopathy. His skin exam showed…See More
Sep 8
Donna D'Alessandro posted a blog post

What Causes Testicular Pain?

Story A 17-year-old male came to clinic with a 3 week history of what he described as intermittent left testicular pain. It occurred only during the day and would occur randomly, lasting for a few seconds to a few minutes. The pain occurred mainly in the lower abdomen but would come into the upper scrotal area. He described it as a pressure-type pain not a stabbing/cutting pain. He said there was no inguinal masses. He denied sexual activity, masturbation, trauma, or excessive exertion. He denied any inguinal swelling, swelling or erythema of the scrotum, testes or penis and no penile discharge. He was an athlete who wore compression clothing but not a protective cup or athletic supporter. The review of systems showed no fever, chills, nausea, emesis, constipation, diarrhea or dysuria.The pertinent physical exam showed normal vital signs and growth parameters. His genitourinary examination showed Tanner V pubertal changes with no skin changes, erythema or edema. There was no specific…See More
Sep 1
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Aug 29
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Donna D'Alessandro posted a blog post

How Common Is Developmental Dysplasia of the Hip in Infants With Breech Presentation?

StoryA 1-week-old female came to clinic for her health supervision visit. Breastfeeding was going well and mild clinical jaundice had resolved. The past medical history showed a full-term female with no prenatal risk factors who had been born by Cesarean section for breech presentation. The family history was negative for orthopaedic issues.The pertinent physical exam showed an alert infant. Her weight was 3.26 kg (50%), length of 48% (50%) and head circumference of 35 cm (90%). Her examination was notable for erythema toxicum neonatorum on her cheeks and a normal hip examination. The diagnosis of of a healthy female was made and routine parent education was given. The physician did schedule a screening hip ultrasound because of the breech delivery. The patient's clinical course at 1 month found her to be in good health with growth parameters consistent with birth. The radiologic evaluation of a hip ultrasound showed developmental dysplasia of the left hip. The patient was sent to…See More
Aug 25
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Aug 20
Donna D'Alessandro posted a blog post

What Causes Proteinuria?

StoryA 16-year-old female came to clinic because of 2 days of dysuria. She was having some increased frequency and also pain with urination. She wasn't sure if the pain began with the bladder contracting or when her urine stream touched her genital area. She denied fever, chills, nausea, emesis, constipation or pain with defecation. She also denied previous bladder infections or sexual activity. The family history was negative for renal disease or hearing problems. The social history showed her to be a cross-country runner who had increased her mileage the past week by almost 50%. The review of systems was negative.The pertinent physical exam showed a healthy female with no distress. Her blood pressure was 106/62, pulse of 68 and respiratory rate of 16. She was afebrile and her growth parameters showed a weight of 25%, and height of 75%, consistent with previous measurements. Her abdomen examination was negative including no suprapubic or costovertebral angle tenderness. Genitourinary…See More
Aug 18
JULIO CESAR NEYRA PINTO commented on JULIO CESAR NEYRA PINTO's blog post 'chylous pericardial effusion'
"In Lima they just observed her. One month later she came back to our hospital with a chylothorax. A thorax surgeon did drained this fluid and also cut her thoracic duct and with this, she finally recovered. Now She is doing ok, her health is…"
Jul 31
Donna D'Alessandro posted a blog post

What Causes Abdominal Distention?

Story Patient Presentation A 10-year-old male came to the emergency room with a several day history of abdominal distension and generalized abdominal pain. The patient and family could provide few details but the pain was located periumbilically, occurred only during the day and would come and go. He occasionally felt nauseous but had no emesis. He denied any fever, chills, upper respiratory illnesses or urinary symptoms. He was unsure when his last bowel movement was. He had a history of constipation where his bowel movements were large enough to block up the toilet. He said that this didn't feel like the pain he had with his appendicitis 1 year previously. The past medical history was positive for being underimmunized and having an appendectomy 1 year previously. The social history revealed financial difficulties. The mother also had a lower intellect with some difficulties with daily activities.The pertinent physical exam showed a well-appearing male with normal vital signs. His…See More
Jul 21
 
 
 

Learning Portfolio Posts

What Medicines Should Be Avoided with G6PD Deficiency?

Posted by Donna D'Alessandro on September 15, 2014 at 12:30am 0 Comments

Story

A 3-day-old male came to clinic for a weight and bilirubin checkup. He was feeding well every 2-3 hours for 30 minutes. He was having several stools but they still had meconium. He would awaken but seemed sleeper for the past 24 hours per his mother, and she thought he looked more jaundiced. The past medical history showed that he was a 38 week gestation, appropriate-for-gestation-age, infant born vaginally to a G2P2 O+ female with no risk factors. He had an…

Continue

What is Gianotti-Crosti Syndrome?

Posted by Donna D'Alessandro on September 8, 2014 at 12:30am 0 Comments

Story

A 4-year-old male came to clinic with a new rash and a low grade fever that had begun the night before. The mother said that the child had a recent sore throat but had been doing well until the last night when she noticed some papules on his upper legs. In the morning the rash had spread to his thighs and knees, buttocks and upper arms including the elbows. He had none on his face or trunk. The spots were becoming more extensive and were now red whereas the night…

Continue

What Causes Testicular Pain?

Posted by Donna D'Alessandro on September 1, 2014 at 12:30am 0 Comments

Story

A 17-year-old male came to clinic with a 3 week history of what he described as intermittent left testicular pain. It occurred only during the day and would occur randomly, lasting for a few seconds to a few minutes. The pain occurred mainly in the lower abdomen but would come into the upper scrotal area. He described it as a pressure-type pain not a stabbing/cutting pain. He said there was no inguinal masses. He denied sexual activity, masturbation, trauma, or…

Continue

How Common Is Developmental Dysplasia of the Hip in Infants With Breech Presentation?

Posted by Donna D'Alessandro on August 25, 2014 at 12:30am 0 Comments

Story

A 1-week-old female came to clinic for her health supervision visit. Breastfeeding was going well and mild clinical jaundice had resolved. The past medical history showed a full-term female with no prenatal risk factors who had been born by Cesarean section for breech presentation. The family history was negative for orthopaedic issues.

The pertinent physical exam showed an alert infant. Her weight was 3.26 kg (50%), length of 48% (50%)…

Continue

What Causes Proteinuria?

Posted by Donna D'Alessandro on August 18, 2014 at 12:30pm 0 Comments

Story

A 16-year-old female came to clinic because of 2 days of dysuria. She was having some increased frequency and also pain with urination. She wasn't sure if the pain began with the bladder contracting or when her urine stream touched her genital area. She denied fever, chills, nausea, emesis, constipation or pain with defecation. She also denied previous bladder infections or sexual activity. The family history was negative for renal disease or hearing…

Continue

What Causes Abdominal Distention?

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

Story

Patient Presentation

A 10-year-old male came to the emergency room with a several day history of abdominal distension and generalized abdominal pain. The patient and family could provide few details but the pain was located periumbilically, occurred only during the day and would come and go. He occasionally felt nauseous but had no emesis. He denied any fever, chills, upper respiratory illnesses or urinary symptoms. He was unsure when his last bowel…

Continue

What Medications Should Be Avoided with Long QT Syndrome?

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

Story

An 11-year-old female came to clinic with a hacking cough for the past 4 days. It was bothering her during the day and night. She had no rhinorrhea, fever, nausea, vomiting or shortness of breath. Overall she just didn't feel well but was attending school and doing her sports activities. She had multiple family members with upper respiratory tract infection symptoms over the past 2 weeks. Her father had been diagnosed with mycoplasma pneumonia 2 days ago after he…

Continue

How Much Cetirizine Can Be Used?

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

Story

Patient Presentation

A 6-year-old male came to clinic with a history of seasonal allergic rhinitis. Loratadine usually controlled his symptoms well, but this spring seemed to be worse than usual. His mother was giving him the medicine in the morning but by the evening he was having increased sneezing, watery eyes and his mouth was itching. He was having problems sleeping also because of the increased rhinorrhea and was more tired during the day. "I…

Continue

What Causes Neck Stiffness?

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

Story

A 14-year-old female came to clinic with a 3-day history of increasing neck stiffness. The pain was mainly left-sided and got worse as the day went on. She was also having generalized headaches in the evening that would resolve with sleep. She denied fevers, chills, nausea, emesis, or photophobia or other pain. She denied numbness or tingling in shoulders or arms. The past medical history showed that she was fully vaccinated and had 3 migraine headaches since…

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What are the Most Common Motor and Vocal Tics?

Posted by Donna D'Alessandro on June 23, 2014 at 12:30am 0 Comments

Story

A previously healthy 10-year-old female came to clinic with new onset of eye blinking that the mother had noticed for 2 weeks. The patient initially didn't notice it, but was becoming more aware and said that she noticed it occurred more when she was upset or excited. Her friends had not noticed it. The eye blinking didn't seem to bother her in general and the mother said that she saw only increased eye blinking in the evenings particularly when she was tired. They…

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