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Lin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. In the first hospital, he was suspected to have EBV infection and "infectious mononucleosis". He was given intravenous ganciclovir at first. However, Lin's oral temperature still fluctuated at around 38.5°C after the regimen and complained of weakness, significant headache, and bilateral elbow joints pain. He then visited another outpatient clinic of a pediatric hospital, and physical examination in the department shows: well physical development, conscious, steady breathing, well mental response, no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness but complain elbows pain. He was asked to have a bone marrow biopsy. He also complained of a frontal headache accompanied by vomiting, twice. Both vomits happened after lunch with a small amount of stomach content. No fever, obvious dizziness and chest tightness. He also had self-limited headaches in the past and recovered without medication. 1. How do you know whether the bone marrow is taken successfully during the biopsy? 2. Are the headache and vomit related to initial diagnosis or underlying disease? Are all of the Lin's symptoms caused only by his underlying disease or also by other causes? 3. What is the pathogenesis of vomiting at different ages? What is the difference of pathogenesis difference between adult and children?

Lin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. In the first hospital, he was suspected to have EBV infection and "infectious mononucleosis". He was given intravenous ganciclovir at first. However, Lin's oral temperature still fluctuated at around 38.5°C after the regimen and complained of weakness, significant headache, and bilateral elbow joints pain. He then visited another outpatient clinic of a pediatric hospital, and physical examination in the department shows: well physical development, conscious, steady breathing, well mental response, no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness but complain elbows pain. He was asked to have a bone marrow biopsy. He also complained of a frontal headache accompanied by vomiting, twice. Both vomits happened after lunch with a small amount of stomach content. No fever, obvious dizziness and chest tightness. He also had self-limited headaches in the past and recovered without medication. 1. How do you know whether the bone marrow is taken successfully during the biopsy? 2. Are the headache and vomit related to initial diagnosis or underlying disease? Are all of the Lin's symptoms caused only by his underlying disease or also by other causes? 3. What is the pathogenesis of vomiting at different ages? What is the difference of pathogenesis difference between adult and children?

Human Anatomy & Physiology (11th Edition)
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
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Lin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. In the first hospital, he was suspected to have EBV infection and "infectious mononucleosis". He was given intravenous ganciclovir at first. However, Lin's oral temperature still fluctuated at around 38.5°C after the regimen and complained of weakness, significant headache, and bilateral elbow joints pain. He then visited another outpatient clinic of a pediatric hospital, and physical examination in the department shows: well physical development, conscious, steady breathing, well mental response, no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness but complain elbows pain. He was asked to have a bone marrow biopsy. He also complained of a frontal headache accompanied by vomiting, twice. Both vomits happened after lunch with a small amount of stomach content. No fever, obvious dizziness and chest tightness. He also had self-limited headaches in the past and recovered without medication. 1. How do you know whether the bone marrow is taken successfully during the biopsy? 2. Are the headache and vomit related to initial diagnosis or underlying disease? Are all of the Lin's symptoms caused only by his underlying disease or also by other causes? 3. What is the pathogenesis of vomiting at different ages? What is the difference of pathogenesis difference between adult and children?
Transcribed Image Text:Lin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. In the first hospital, he was suspected to have EBV infection and "infectious mononucleosis". He was given intravenous ganciclovir at first. However, Lin's oral temperature still fluctuated at around 38.5°C after the regimen and complained of weakness, significant headache, and bilateral elbow joints pain. He then visited another outpatient clinic of a pediatric hospital, and physical examination in the department shows: well physical development, conscious, steady breathing, well mental response, no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness but complain elbows pain. He was asked to have a bone marrow biopsy. He also complained of a frontal headache accompanied by vomiting, twice. Both vomits happened after lunch with a small amount of stomach content. No fever, obvious dizziness and chest tightness. He also had self-limited headaches in the past and recovered without medication. 1. How do you know whether the bone marrow is taken successfully during the biopsy? 2. Are the headache and vomit related to initial diagnosis or underlying disease? Are all of the Lin's symptoms caused only by his underlying disease or also by other causes? 3. What is the pathogenesis of vomiting at different ages? What is the difference of pathogenesis difference between adult and children?
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