Diagnostic Dilemma FAQs - Pediatric Oncall

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Diagnostic Dilemma

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Medical Quiz

Interactives

Ask Queries

SPECIALIST ANSWERS

Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

Video Podcast

Videos in Medicines

Medical Training Videos

Clinical Video Resource

Videos on Asthma

Audio Cast

Lecture on Pediatrics

Medical Training Audios

Clinical Audio Resources

Audios on Asthma

Mobile (wap)

Staying connected to Pediatric Oncall is now easier with Pediatric Oncall Mobile . You can now download selected content from the latest issue of Pediatric Oncall.

Research Grant

FIND DIAGNOSIS

VACCINE REMINDER

Get the Vaccine Schedule for your child."

	Specialist Answers
Question Category : Diagnostic Dilemma
15 days old baby 2nd issue of 3rd consanguineous marriage, presented with respiratory distress and mild abdominal distension since one day. g1--21/2 abortion o/e hr-150 rr-90 severe pallor +++ no gross anomalies s/e p/a-- hepatomegaly--6cm with span 9cm splenomegaly--2cm other system -nad ??? clinical diagnosis. Check Out the Answer
Question Category : Diagnostic Dilemma
10 year old male child, average built presented with vomiting and headache. No fever no convulsion no abdominal pain no loose motions no otorrhoea no ringing bell sensation in ear no earache. On 2nd day of admission his vomit contained worms. o/e: BP 94/70 RR:18 PR:92 CNS:oriented in t/s/p but drowsy. No cranial nerve palsy no F N D sensory motor :nad, no neck rigidity, no nystagmus no other cerebellar signs. unable to sit in upright posture able to lie in recumbent posture as and when made upright c/o giddiness nausea and followed by vomiting. was started on iv ondensetron,rantac given antihelminthic emperically given mannitol for one day no improvement in patient's condition even after two days of treatment. p/a: no distension, guarding, rigidity, tenderness, softL0 S0 CBC: nad BUN CREAT SGPT SGOT BILI normal PROTIENS 7.8 ALBUMIN 3 GLOB 4.8 ELECTOLYTES normal USG abd: nad CT BRAIN: nad. Check Out the Answer
Question Category : Diagnostic Dilemma
10 years old female patient with 15 days history of high grade fever, fresh bleed per rectum; on examination no hepatosplenomegaly, pallor+++,no purpura or petechiae, urine output adequate, on investigation Hb 2.4gm/dl,TLC 2400/cumm,platelet 2000/cumm. Check Out the Answer
Question Category : Diagnostic Dilemma
A 16 years old girl comes with a complaint of hyperpigmentation of skin confined to area under the nail beds in both her hands. it is seen in some fingers only and has started 2 weeks back. what is the cause of this please?? could it be just the cold temperature affecting the skin? Check Out the Answer
Question Category : Diagnostic Dilemma
A 12 years old boy was presented with fever up to 39.6 every day, mild spleen and lever enlargement, transient arthralgia. Body weight loss about 8 kg for 3 weeks, CRP and ESR increased. Other routine lab tests are normal. What might be the diagnosis and how to proceed? Check Out the Answer
Question Category : Diagnostic Dilemma
9 years old girl presented with high fever with significant cervical lymphadenopathy. spleen initially was 2 cm and no other significant clinical finding. routine inv, GBP, MP, widal, urine cultures, MX test, usg, X-RAY CHEST, USG, ECHO , FNAC lymph node all were non conclusive. has received antimalarial, iv ceftriaxone and other supportive Tt prior to admission. No history of cough, joints pain, vomiting, significant weight loss. Kindly suggest probable Diagnosis and further investigations. bone marrow, collagen profile and paul bunnel test report awaited. Check Out the Answer
Question Category : Diagnostic Dilemma
Dear sir 14 years old female present with headache and polyurea. Her weight is 105 kg....Bp;170/110,the following link is her photo; http://img114.imageshack.us/img114/4832/picture003xm1.jpg How you manage this case...? Check Out the Answer
Question Category : Diagnostic Dilemma
A 4 year old child had hypernatremia with sodium >240 mosm/l glucose >500, and acidosis without ketosis. Is this a case of Diabetic Hyperosmolarity or poisoning? Check Out the Answer
Question Category : Diagnostic Dilemma
Dear Sir my patient is a 18 months old child present with severe distress, cyanosis and copious salivation. On examination irritable child cyanosed with excessive salivation, conscious. Tonsil's are normal. Chest exam reveal bilateral creps.noisy throat. No history of poisoning,insect bite or F.B inhalation.CXR is normal. Under g.a laryngoscope+ suction was done with -ve result but the patient.improved for 2hours during which the mother started feeding. The mother mentioned that the milk come out through the nose. After 2 hours the same picture recur or even worse. How to manage this case.....? I referred the case to syria pending the result. Check Out the Answer
Question Category : Diagnostic Dilemma
A 10 month old infant presented with sudden onset of pain and tenderness in right lower limb without any history of fever or trauma. on investigation the x-ray of that limb was normal, Hb was 8.2%, retic count was 0.5%, TLC was 15, 5000, MCV was 74, MCH was 23, GBP showed microcytic hypochromic picture. Child was started on antibiotics. Pain and tenderness got relieved but TLC did not come down. what will be the possible diagnosis? Check Out the Answer
Question Category : Diagnostic Dilemma
1 year old boy, with arthrogryposis multiplex congenita, severe hypo protinemia, malnourished, developmental delay...what could be the diagnosis? Check Out the Answer
Question Category : Diagnostic Dilemma
Sir I have a newborn in my NICU who is now 6 days old. He had one episode of asymptomatic hypoglycemia which was corrected now. History of previous neonatal death to a consanguineous parents. urine metabolic screening positive for MPH(Hurler)is this hypoglycemia related to this? What is the neonatal outcome? IEM results awaited. What are differential diagnosis? please answer. Septic workup not contributory. Check Out the Answer
Question Category : Diagnostic Dilemma
I have a patient, 9 years old, female with good health, complains only of tooth grinding during sleep. On routine investigation we discover that her serum Calcium is 7.5 mg/dl. We repeat the test after 12h fasting, the result is the same. She has tooth problem but good skeleton and body weight. After a year of maintainence dose of Calcium and Vitamin D and egg milk cheese food, the result is the same. The question is why this Calcium is low? What tests to do else? What is the treatment? Check Out the Answer
Question Category : Diagnostic Dilemma
1.Can u please tell me the reference where its given how to calculate the upper segment, lower segment ratio? Not how to measure. We need the reference to calculate. 2.What is the chance for the recurrence of cleft lip/palate if the parent is normal and if the parents are also affected? 3.Can bilious vomiting be taken lightly? 4.When to call there is an intestinal obstruction radiologically? Other words what are the normal fluid levels seen in the plain x-ray abdomen erect view? 5. For a child who has taken iv Immunoglobulin say for kawasaki disease, how long u advice live virus vaccines to be avoided? So for a 4month old child who was given iv Ig, should not we give measles vaccine at 9th month or due to its ineffectiveness, should we repeat the MMR at 15th month also? Why is that only parenteral live virus vaccines are contra-indicated? PLEASE HELP. Check Out the Answer
Question Category : Diagnostic Dilemma
An eight years old male child, with history of birth asphyxia and delayed milestones had sudden onset of aphasia after returning from school, child also has difficulty in swallowing. E.N.T. check-up is normal(no throat problem),no fever, no vomiting. on examination, gag reflux is normal and no neurological deficit. Over the period of 5 days gradually he has started taking orally liquids only. Insight of child is normal, neither agitated nor depressed. He is communicating with gestures (like noding of head etc).orientation and intelligence is normal. This child is a single child in the joint family and is over pampered. This child is said to be very stubborn. please help me with diagnosis? Check Out the Answer
Question Category : Diagnostic Dilemma
A baby born via LSCS, normal APGAR, immediate cry, normal and healthy term AGA develops jerky respiration at 15 days of age, as if to inhale air through the mouth pulling it in by the tongue, mother comes at 1 month of age with the complaint of decreased oral feeding, on examination - Pierre Robin sequence, poor neonatal reflexes, hypotonia, spalding of skull bones, head circumference at birth 34.5 cm, no increase and lethargy. Investigations - CXR normal, echo normal and metabolic panel normal. (H/o death of a normal 3 yr old sibling 3 yrs back - undiagnosed - developmental regression for 4-5 months before death - mitochondrial myopathy??) Present 1 month old baby on full feed through NG tube and occupational therapy to improve swallowing and muscle tone - improvement in tone and activity noticeable since beginning of OT since 5 days, but jerky respiration persists. DIAGNOSIS AND THERAPY? Check Out the Answer

Diseases & Conditions

Pediatric Oncall Journal

Case Reports

Original Research

Letter to Editor