Asthma comorbidity

7yr girl with asthma but has inspiratory dyspnea as well

This is a spirometry  (illustration is not related to this patient)

Hint:

What phase of breathing does stridor usually manifest?

Resource:

Wheezing and vocal cord dysfunction mimicking asthma

PMID: 11140406 [PubMed - indexed for MEDLINE]

"Rash"ionale 1

This is an infant on a parent lap. (The following questions are not linked to each other and describes seperate entity)

1.What is the most life saving management if the child is "ill appearing" with high fever?



2.What is the role of steroids if your diagnosis is a "vasculitis disorder" in a well appearing child?

http://www.ncbi.nlm.nih.gov/pubmed/22311342


3. Name the childhood vaccine associated with "autoimmune" disease presenting like this.


4. What is the indication for bone marrow aspiration in this child?

Arch Pediatr Adolesc Med. 1998 Apr;152(4):345-7.

Blood teaser

9 month infant admitted for skin abscess. What is the hematologic diagnosis?  Name the hematologic index that would help further test for this diagnosis.

WBC  (K/CMM)	7.8
RBC  (M/CMM)	4.66
Hb  (g/dL)	9.7
HcT (%)	29.6
MCV (fL)	63.5
MCH (pg)	20.8
MCHC (g/dL)	32.7
RDW (%)	17.0
PLT (K/CMM)	211
MPV (fL)	8.3

Hint:

The six discrimination indices are:

• Mentzer Index  (MI): MCV / RBC
• Green & King Index (G&K): MCV  × RDW / (Hb × 100)
• RDW Index (RDWI): MCV × RDW / RBC
• England & Fraser Index  (E&F): MCV − RBC-(5 × Hb) − k [k = 6.4]
• RDW
• RBC count

 

 

Based on one of the above index what is next test to order?

 

1. Hb A2 (Hemoglobin electrophoresis)

2. serum ferritin

3. vitamin B12

4. bone marrow aspiration

5. serum lead

Nagging neck pain

10 yr old boy  with neck pain and high fever. He had two weeks of upper respiratory tract infection.

What is the diagnosis? And identify the markers.

What is the diagnosis?

5 year old with massive hepatomegaly

CT Abdomen shows increased vascularity and calcification in the liver.

What happened to this patient?

This is an infant who was post-op and started getting drowsy while on intravenous and oral fluids.
What is the explanation?

Legend: Na-sodium; S.Osm- serum osmolality; U.Osm-urine osmolality;
I/O- input/output fluids; ins- fluid intake (oral and intravenous)

CT Head without contrast