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Question Category:Diagnostic dilemma |
8 day old male baby,born of nonconsaguinous marriage,with compaints of passing brown colour urine,staining the nappies brown .otherthan that baby has no problems.previous male sibling had similr complaints,now the staining has decreased.no history of similar compaints in the parents.urine dep -nil,no RBCsin urine.how to proceed to arrive at a diagnosis.
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Question Category:Diagnostic dilemma |
acase of 16,month, old presented by fever which respond to antipyretics after 2 days generalised lymphadenopathy appear,we did monospot test which was negative and differential leucocytic count was neutrophils 15%,lymphocytes 80%,monocytes 4%,eosinophils 1%basophils 0%,CBC was Hb 11.0,haematocrit 33.8, RBCs 4.3, MCV 79,MCH 26,MCHC 33,platelets 130,total WBCs 5.4,there is mild splenomegaly what is the diagnosis?
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Question Category:Diagnostic dilemma |
Can I use this site to request help with a differential for an I.D. problem? If so, here is the presentation: 18 year old black female with 3-4 days of fever 102-103, myalgias arms and legs, headache wihout meningismus, although h/a with motion of head and her eyes; NO rash, menses occuring, in the carribean one week earlier with an overnight with family in Jamaica, NO hx tic bite; maybe one or two mosquitoe bites, sweats and chills at night 1-2 nights. No real cough of any signicance. Mom with history of colitis (?u.c.), and lupus. PExam notable: not toxic, although ill with malaise. Moderate upper lid edema without erythema or tenderness. No other visible edema. Small residual induration without pain or erythema at upper gluteal cleft. She is on the last day of Bactrim for treatment of a pilonidal cust infection. It looks good and appears to be a red herring. Lab: WBC 2.5 (leukopenia), nl diff, nl h/h; u/a +3 blood but MENSES; neg protein. CRP, Sed RAte, Blood culture, CMP pending. Your thoughts???? Thanks, Marc Tanenbaum, MD Atlanta, GA
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Question Category:Diagnostic dilemma |
a mother of female pateint came to my clinic and asked me about something strange..that her daughter aged 14 years old were yawning and opening her mouth widely and suddenelly a crow came on her head and throw its feces in her mouth suddenly..the girl had blusish discoloraion of her mouth margins and coldness of her hands and sore throat.....WHAT SHOULD I DO FOR THIS CASE?....
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Question Category:Diagnostic dilemma |
A 5 five years old boy, for the last 8 months having sterotyped symptoms of feeling unwell, headache,hallucinations and vomiting. he has documeted history of fever of upto 104F. giving calpol relievs the fever and after fever is relieved ,he is normal in his routine work. He has 10-12episodes in a day and use to occur every 3 days, and then every 3 weeks and such so that he has now 10-15 episodes since Jananuary. There is no consitutional symptoms. No tummy pain, no joint pains. On examination now he has a temp of 104F. Apart from temperature , examination is absoultely normal. His full blood count, LFT, Immunoglobulins are normal. Only worry is the raised CRP of 42. Please help me to arrive at the diagnosis and help this little kid. Waiitng anxiouxly for the reply soon
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Question Category:Diagnostic dilemma |
7 months old female child previously treated for obstructive hydrocephalous with VP Shunt at the age of 4 months, now presenting with acute onset of fever and floppiness of all limbs of 4 days duration. O/E Hypotonia more in LL, DTR just present, Plantar- Bil. Flexor. Other systems- WNL. WAT`S probable clinical diagnosis before proceeding to Investigations?
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Question Category:Diagnostic dilemma |
Hello,I am a pediatrian.I have a patient.He is 9month.He has short stature,low weight and small head circumference.He has not have increase in his head circumference.In his lab test :TSH=9 &mild anemia. I prescribed levothyroxin 12.5microgram & ferrous sulfate for him.After pne week I increased dose of levothyroxine to 19microgram.Immediately after that he became restlss.He just took one dose of 19microgram & I immediately discontinued it,but he has not changed & even worse. He is severly pale,tachypneic & restless.?Hb=10 PLT=120000 RBC=3.500000 WBC=125000 Would you please guide me?Is that because of levothyroxine? Thank you.
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Question Category:Diagnostic dilemma |
sending herrewith case history. kindly comment on differential diagnosis and management. 11 year female. parent non-consanguious marriage. rajsthani presented with c/o-abdominal pain since 20 days,tired on walking or accustomed work but no dyspnoea.vomiting -once every 2nd or 3rd day nonprojectile no relation to food.mild fever daily resolves after antibiotics.all comp since 20 days . father also noticed yellowness of eyes since 20 days. all comp more or less at same time . baby admitted to a hospital 10 days before. 2 blood transfusion were given. O/E-pallor++ icterus++ vital stable , hepatomegaly 8cm firm regular surface, well defined edge, splenomegaly 5cm along axis, notch not felt soft, previous h/o of exactly similar c/o hospitalisation and transfusion 6 month back given 2transfusion at that time in between absolutely symptomfree . please guide aboutr d/d and diagnostic approach
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Question Category:Diagnostic dilemma |
i would be happy if some one helps in diagnosis of this problem. 13 yr old child presented to us with fever with chills recurrent episodes since her 9 yrs of age, every time requiring long duration of hospital stay. We got hepato splenomegaly(massive) and few temporary lymph nodes. every work up for malaria, dengue, UTI, Cholangitis came negative. Then we proceeded with work up for connective tissue disorders which is also negative. Bone Marrow showed Erythroid Hyperplasia. This time when she was admitted, she collapsed and went into picture of DIC. It was very difficult for us to revive her out of it. Brucella, Leishmaniasis work up was also negative. THe only positive report we got in the previous admission was TB PCR positivity in CSF.We started her empirically on ATT. We feel she has some immuno deficiency that makes her succumb to recurrent fatal infections. How ever her HIV Status was negative. Whole body gallium scan also showed nothing. At present she is out of ICU in the ward...... waiting for the next episode of infection. Can u help us in diagnosis? How to rule out immunodeficiency? We have sent samples for complement analysis and Immunoglobulin Electrophoresis and results are awaited. Work up of sarcoidosis is going on. What else to rule out?
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Question Category:Diagnostic dilemma |
I would like to bring to your attention the case of a full term baby weighing 3.2 kgs at birth with normal birth history who developed tonic clonic convulsions lasting few seconds at 14 days of age, 2 episodes all in all. There was no fever or reduced feeding during or after the episodes. On examination there was no organomegaly or abnormality found on general examination regarding congenital anomaly or abnormal facies. His random blood sugar was normal. But his serum calcium turned out to be 4mg/dl. While his serum sodium was normal, his serum potassium was 6meq. After managing for hypocalcemia ( inj. Calcium gluconate 2ml/kg iv stat and maintenance) his electrolytes were repeated. His serum calcium had improved but still low but his serum potassium had increased over the hours to7meq. Baby’s serum phosphate, vitamin D levels, serum alkaline phosphatase have not been done. His GBP and hemogram are also normal. The renal and liver profiles are normal. The child’s mother had an uneventful antenatal history and suffers from no known systemic illness. Mother’s serum PTH and Vitamin D levels also had not been done. The baby was on mixed top and breast-feeding since birth. After discharge from the hospital his serum calcium is 9.2mg% and serum potassium is 6meq. Can you suggest me some causes for the strange electrolyte levels and its treatment incase convulsions recur. The parents have reported them once after discharge for a brief period despite normal serum calcium levels. Please reply at the earliest..
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