As a young doctor on call in one of the leading hospital in Nigeria, I had a patient, an 8 year old girl that presented with breathing difficulty accompanied with wheeze. The picture fitted so well into an acute asthmatic attack and we began management along that line. There was an initial improvement but this improvement wasn 't as expected and this made us probe further. The patient’s mother attested to the fact
R.J. is a 15-year-old boy with a history of asthma diagnosed at age 8. His asthma episodes are triggered by exposure to cats and various plant pollens. He has been using his albuterol inhaler 10 to 12 times per day over the last 3 days and is continuing to wheeze. He normally needs his inhaler only occasionally (2 or 3 times per week). He takes no other medications and has no other known medical conditions. Physical examination reveals moderate respiratory distress with a respiratory rate of 32, oximetry 90%, peak expiratory flow rate (PEFR) 60% of predicted, and expiratory wheezing.
Hereditary Angioedema is the rarest of Angioedema’s and Urticaria is very uncommon with this type of angioedema. Hereditary Angioedema is a result of Blood levels of the protein C1-esterase inhibitor being very low. C1-esterase inhibitor protein plays a significant role in the regulating of the immune system and without it cases if our immune system. Hereditary Angioedema cases are usually Chronic rather than acute with very gradual development. Hereditary Angioedema It can be triggered by infection, trauma and
The clinical presentation of childhood EGPA can be diverse, with involvement of different organ systems. Pulmonary infiltrates, asthma symptoms and sinusitis are the most common respiratory diseases. Eosinophilia in the peripheral spread, vasculitis and polyneuropathy were suggested to us in this case by EGPA. Although EGPA is a rare disease, it has to be considered by clinicians in children presenting with hyper eosinophilia. Although there were no respiratory symptoms, findings consistent with typical EGPA might be found on imaging. It is absolutely necessary to examine the respiratory tract with advanced imaging methods in such patients. In cases suspected of EGPA, even without respiratory symptoms, detailed imaging and pathology will establish
It also arises, typically, in three phases. The allergic stage, the eosinophilic phase, and the vasculitic phase. Because of this staging of the disease, the diagnosing of this disorder is very difficult, and is why it can only be fully diagnosed in its later, and more lethal stages. With this in mind, these are the most prominent symptoms of Churg Strauss in each of its stages. In the allergic stage of the disease, the patient will experience asthma, allergic rhinitis, and sinusitis. In the Eosinophilic stage, the symptoms are: fever, loss of appetite, weight loss, rectal bleeding, asthma, fatigue, cough, abdominal pain, gastrointestinal bleeding, and chronic and frequent nose bleeds. Lastly, in the vasculitic stage, the symptoms that will present are Rash or skin sores, joint aches and swelling, severe pain, peripheral neuropathy, or the numbness and tingling in your hands and feet, severe abdominal pain, diarrhea, nausea, vomiting, dyspnea, or shortness of breath often from asthma and in some cases even congestive heart failure, hemoptysis, or the coughing up of blood, chest pain, irregular heartbeat, hematuria, or blood in
Several studies have suggested that PDA occurs in premature babies due to the lungs being underdeveloped and poor metabolizers of prostaglandins. Other risk factors that may be associated with an infant having a PDA is a positive family history of cardiac defects and genetically linked conditions like Down syndrome. Maternal infection with German measles during pregnancy can cause damaging effects to the fetal heart and circulatory system and put the infant at greater risk of acquiring a PDA. Studies have also shown that children born at higher altitudes have an increased susceptibility of having a PDA.
History of Current Illness: First occurrence of an abnormal wheezing and breathing issues occurred when he was three years old. His grandparents had recently obtained a canine animal (dog), which was when these episodes of abnormal wheezing began occurring with increasing frequency every time he returned to his grandparents’ house. Starting at four years of age, he also began having horrible coughing/wheezing around the beginning of spring and end of summer with the changing of the seasons. As Frank got older in age and began participating in sports activities, his breathing issues would tend to flare-up more often. By the age of ten, he had hospitalized three times for issues involving uncontrolled asthma. He was treated with intravenous steroids and prescribed bronchodilators to minimize inflammation and muscle constriction in his airways. Additionally, he had been to the ER numerous times suffering from serious asthma onslaughts. History also includes sinus infections in the maxillary portions of the face with green fluid emissions from his nose involving increased asthma complications and eczema (atopic dermatitis) as an
Choice “D” is not the best answer. Wiskott-Aldrich syndrome (WAS) is an X-linked recessive immune disorder with the characteristic triad of recurrent bacterial sinopulmonary infections, eczema (atopiclike dermatitis), and a bleeding diathesis caused by thrombocytopenia and platelet abnormalities. Mortality or infection from EBV is not directly increased in this
Sam is a pediatric male child that presents with fever, a productive cough with green sputum, gingivitis, and pneumonia in his right upper lobe. He also has a history of frequent bacterial infections and pneumonia. Diagnostic tests on his deep sputum samples show he has Pulmonary Nocardiosis. Further special tests, specifically Dihydrorhodamine Flow Cytometry and Nitroblue Tetrazolium, indicate that Sam’s infections are due to him inheriting the Chronic Granulomatous Disease (CGD) immunodeficient disorder. Sam’s family would predictably want to know: how is CGD managed, and what are the different therapeutic outcomes?
The phase diagram is a simulator representing how much pressure can be added and the different forms of your substance (whether it's liquid, solid or gas.) in different environments and put to observation tests. The three regions are solid, liquid and gas. Gas when heated spreads everywhere and moves rapidly. When gas is frozen it falls to the bottom and gets stuck together as if it was a solid or a liquid. Liquid when heated boils, then turns into gas and builds up pressure. Eventually enough pressure to blow the lid off. Liquid when frozen turns into a solid. Solids when heated turns into a liquid, then soon evaporates and becomes a gas. When a solid is frozen it stays as a solid.
Case Presentation: An otherwise healthy 9-month-old boy was brought to the Emergency Department by respite foster parents with a chief complaint of unusual bruises and marks on his skin. Two days prior to the ER visit, the respite foster parents had noticed some left eye redness and swelling, which by day of presentation had progressed to a large swollen blue-black lesion on his left cheek and new scattered bluish lesions on his thighs. The child had been diagnosed with a viral upper respiratory illness three weeks prior and had some lingering nasal congestion with tactile temperatures for the past week, but was otherwise acting very well, eating normally, and was not fussy. His past medical history is remarkable for a pre-term birth at 31 and 5/7 weeks gestation via vaginal delivery. The biological mother’s pregnancy was complicated by premature prolonged rupture of membranes and polysubstance abuse. He was not on any medications and has no known allergies. On physical examination in the ED, his vital signs are within normal limits for age. He is well-appearing and in no acute distress. Head and neck examinations are within normal limits with a soft and open anterior fontanelle. Cardiovascular, pulmonary and abdominal examinations also yield no abnormalities. Skin findings include an obvious large targetoid ecchymosis with underlying edema on the left cheek, a right posterior auricular ecchymosis, as well as several scattered annular blue-black ecchymoses on the bilateral
The disease is characterized by infiltration of foamy macrophages into various tissues with associated xanthogranulomas inflammation. ECD is a relatively rare condition with between 400-500 cases described in the published literature over the last 80 years. The disease is more common in men with one study showing 73% males out of 52 patients with disease reported . Although the disease can present in children, most patients are diagnosed in
pyogenes are not common if treated within an appropriate time period. Some common complications that could arise however are cervical lymphadenitis, peritonsillar (retropharyngeal abscess), sinusitis, otitis media, meningitis, bacteraemia, endocarditis and pneumonia. (7) Abscesses are the accumulation of pus within an inflamed area. Otitis media is when parts of the middle ear are inflamed causing problems with your auditory abilities. Meningitis is inflammation of the meninges layer protecting the brain. Bacteraemia is the spread of bacteria within an individuals blood. Endocarditis occurs when the endocardium layer of the heart is inflamed. (6) Most of these complications arise when the pathogen spreads into deeper layers within our body through lymphatic fluid or blood (7). An important complication that is usually caused by a erythrogenic toxin. This toxin acts as a superantigens and can be present the first time someone encounters this ifection. Symptoms of Scarlet fever are pink rash on the superficial layers of the skin, strawberry tongue that is inflamed and a fever. Further complications following scarlet fever are glomerulonephritis and rheumatic fever. Glomerulonephritis effects the kidneys and causes inflammation. Rheumatic fever effects the heart and is not infectious. When an individual has rheumatic fever, antibodies produced to the pathogenic antigen cross react with our own tissues, specifically heart tissue. This
The Pole Vault can be divided into four phases: approach, pole bending, pole straightening, release and clearance. The following is a description of each phase step by step, with images depicting the events that divide them.
Based on the history of Kawasaki syndrome , it is stated that the first case of an unusual illness with rash and fever had been detected in a 4 year old child by one of the doctor in Japan named Tomisaku Kawasaki . Specifically,this first case had been found at the Red Cross Hospital in Tokyo, Japan .Kawasaki syndrome is an illness that frequently occurs among young children. It usually affects children ages 1 to 2 years and is less common in children which age more than 8 years. This syndrome is not a contagious disease but has the ability to harm the coronal artery of the children which functions to carry blood to heart muscles . Kawasaki syndrome can be categorised as one of the serious illness in the medical field since it has the