Question Category:Diagnostic dilemma |
15 days old baby 2nd issue of 3rd*cong marrg. presented with resp. distress and mild abd dist. since one day. g1--21/2 abortion abortion o/e hr-150 rr-90 severe pallor +++ no gross anomalies s/e p/a-- hepatomegaly--6cm with span 9cm speenomegaly--2cm other system -nad ???clinical diagnosis
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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 vomitus 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 .
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Question Category:Diagnostic dilemma |
10 yrs 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 investigatio Hb 2.4gm/dl,TLC 2400/cumm,platelet 2000/cumm.
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Question Category:Diagnostic dilemma |
a 16yr 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 2weeks back.what is the cause of this please??could it be just the cold temp affecting the skin?
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Question Category:Diagnostic dilemma |
12 years old boy who presneted with fever up to 39.6 every day, mild spleen and lever enlargementq 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?
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Question Category:Diagnostic dilemma |
9 yr 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 recvd antimalarials, iv ceftriaxone and other supportive Tt prior to admission. no history of cough, joints pain, vomiting,significant wt loss. kindly suggest probable Dx and furher inv. bone marrow, collagen profile and paul bunnel test report awaited.
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Question Category:Diagnostic dilemma |
Dear sir 14y female present with headache and poly urea.Her wt.is 105kg....Bp;170/110,the following link is her photo; http://img114.imageshack.us/img114/4832/picture003xm1.jpg How you manage this case...?
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Question Category:Diagnostic dilemma |
A 4 yo child had hypernatremia with sodium >240 mosm/l glucose >500, and acidosis w/o ketosis. Is this a case of Diabetic Hyperosmolarity or poisoning?
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Question Category:Diagnostic dilemma |
Dear Sir 18m old child present with sever distress ,cyanosis and copious salivation.O/E irritable child cyanosed with excessive salivation,conscious.Tonsilles 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 pt.improved for 2h during which start feeding.The mother mention that the milk come out through the nose.After 2h the same picture recur or even worse. How to manage this case.....? I referred the case to syria pending the result.
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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%,TLCwas 15,5000,MCVwas 74,MCHwas 23,GBPshowed 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?
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Question Category:Diagnostic dilemma |
1 yr old boy,w/ arthrogryposis multiplex congenita,severe hypo protinemia,malnourished,developmental delay...what could be the diagnosis?
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Question Category:Diagnostic dilemma |
Sir I have a newborn in my nicu now 6days old had one episode of asymptomatic hypoglycemia which was corrected now.H/O previous neonatal death to a consanguinous parents.urine metabolic screning positive for MPH(Hurler)is this hypoglycemia related to this? what is the neonatal outcome ?IEM results awaited .what are differential diagnosis ? pls answer . Setic workup not contributory.
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Question Category:Diagnostic dilemma |
i have a patient,9years old,female with good health,complains only of tooth grinding during sleep.on routin investigation we discover that her serum ca 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 maintainance dose of ca and vit d and egg milk cheese food , the result is the same .the question is why this ca is low?what tests to do else?what is the treatment?
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Question Category:Diagnostic dilemma |
1.CAn u pls 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.
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Question Category:Diagnostic dilemma |
an eight years old male child,with h/o birth asphyxia and delayed mile-stones 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 gradualy he has started taking orally liquids only. insight of child is normal, neither aggitated 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?
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Question Category:Diagnostic dilemma |
A baby born via LSCS, normal APGAR, immediate cry, normal n 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 mo of age with the complaint of decreased oral feeding,O/E- Pierre Robin sequence, poor neonatal reflexes, hypotonia, spalding of skull bones, head circmference at birth 34.5 cm, no increase, and lethargy. Investigations - CXR normal, echo normal n metabolic panel normal. (H/o death of a normal 3 yr old sibling 3 yrs back - undiagnosed - developmental regression for 4-5 mo befor death - mitichondrial myopathy??)Present 1 mo 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?
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