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Case (6)

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Admin:
Salah is 7 years old pupil in Primary School Living in Marka. He was born by LSCS in hospital because of contracted pelvic. His mental and motor developments were normal. He had all his vaccines. He was not admitted to hospital before. His mother noticed a month ago that he is complaining of sore throat but she did not take him to the doctor. He was brought to hospital complaining of puffiness of the face and swelling around both eyes only in the morning and he was passing little urine.
1] Mention three questions you would like to ask now.
He was admitted to hospital following history and examination.
2] Mention three physical signs the doctor looked for
3] Mention three possible causes for Salah condition and what is the most likely cause.
4] Mention three important investigations the doctor asked for.
Following the results of the investigation, the doctor started to manage the patient
5] Mention five steps in his management
One night the doctor found his patient in coma and convulsing
6] What is the most important cause for these convulsions?
7] Mention two steps in his management
Three days later the patient improved and regained his consciousness but he was noticed to have difficulty in breathing and did not pass urine for 24 hours. He was transferred urgently to the renal unit.
8] Mention three causes for the transfer
9] What is the most likely treatment he will receive in the renal unit
10] Mention two complications of the treatment he is going to have.
Note:
Who answer all these above questions correctly will be awarded 15 points immediately
and we only accept one answer from each user?
who replies more than once will be kicked out from this competition!
The answers will be displayed after 7 days then we choose the winner and lock the topic
Please Send your answer to me as personal message and vierify here you have answered the question!!
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Thanks
By: Dr.Mahdi 

Muna1:
1] Mention three questions you would like to ask now.
-ASK ABOUT ONSET AND DURATION OF ILLNESS
-COLOR OF URINE
-UPPER RESPIRATORY TRACT INFECTIONS, LIKE PHARYNGITIS
2] Mention three physical signs the doctor looked for
-PERIORBITALAND OR PEDAL EDEMA
-ODEMA (ASCITIES, LOWER LIMB ODEMA, PULMONARY ODEMA, & SACRAL ODEMA)
-HYPERTENSION
-3] Mention three possible causes for Salah condition and what is the most likely cause.
-IgA NEPHROPATHY
-HENOCH-SCHONLEIN PURPURA
-POLYARTRITIS NODOSA

THE MOST LIKELY DIAGNOSIS IS
-POST-STREPTOCOCCAL GN NEPHROTIC SYNDROME
4] Mention three important investigations the doctor asked for.
-URINALYSIS(frank blood ,red cellcast,leucocyte,proteinuria).
-SERUM ASO
-SERUM COMPLEMENT LEVEL(decreased level)
5] Mention five steps in his management
-BED REST
-SALT FREE DIET
-PROTEIN RESTRICTION
-DAILY RECORD OF FLUID INTAKE & OUTPUT
-WEIGHT & REGULAR CHECK UP
6] What is the most important cause for these convulsions?
-UREMIC ENCEPHALOPATHY
7] Mention two steps in his management
-ABORT CONVULSION
-CORRECT ELECTROLYTE IMPALANCE
8] Mention three causes for the transfer
-ACUTE RENAL FAILURE
-CONGESTIVE HEART FAILURE
-PULMONARY ODEMA
9] What is the most likely treatment he will receive in the renal unit
-DIALYSIS
10] Mention two complications of the treatment he is going to have
-ANAPHLYCTIC & HEMOLYTIC REACTION
-HYPOTENSION DURING DIALYSIS

Admin:
Congratulations
The 15 points of this case goes to Muna1
Dr.Mahdi

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