icemaiden
Forum Elite
Topics: 9
Posts: 117
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Hello folks,
I came across these questions and it looked confusing----can someone help out?
1) Which of the foll: is the MOST worrisome developemental sign?
A) 4 month old who does not respond to sound?
B)an 8 month old who does not sit
c)a 16 month old who is not walking but cruising
D) a 2-yr old who only says single words
E)a 5 year old who wets his bed
2)A 2100 g term infant who is lethargic and jittery . He had not fed well since birth and is now 6 hour old.The child is becoming unresponsive and has a generalised seizure. what is the MOST likely diagnosis?
A) sepsis
B)hyperbilirubinemia
C)hypocalcemia
D) hypoglycemia
E) hypoxic ischemic encephalopathy
3)a 4yr old presents with sudden onset pallor,edema and oliguria. She is normally a well child and has no previous complaints other than an episode of diarrhea 10 days ago. Your management should include all of the following EXCEPT
A) careful fluid management
B)antibiotics
C)blood smear
D) assessment of renal function
E) stool culture
My Guess is 1)A 2)D 3)B Any suggestions?
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| drk1980
Forum Guru
Topics: 147
Posts: 1,038
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hi, i go with all your choices cept 2
1) not responsive to sound is naturally a cause for concern.
2) if it were a case of hypoglycemia, the baby wudnt hv been LBW(2100). Sepsis cud hv been it, but iam not sure what the differentiating features are(anyone??).
The most common cause overall of neonatal seizures is Hypoxic-ischemic encephalopathy. Moreover, it goes with this case coz it has presented within 12-24 hrs after birth like it does in HIE.
3)HUS- AB use is not indicated. Although, i dont understand why would we need a stool culture at this point...??
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| drk1980
Forum Guru
Topics: 147
Posts: 1,038
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On second thots, for Q2 it could most likely be sepsis. The constitutional signs- jittery, lethargic, poor feeding, unresponsive probably are more in favor of sepsis than HIE.
Iam not sure abt the timing of presentation though........anyone else?
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| icemaiden
Forum Elite
Topics: 9
Posts: 117
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hey there,
i do agree with you. But i was thinking of hypoglycemia as i read somewhere that neonatal hypoglycemia can occur in SGA babies and they say here that the baby has not fed well since birth.They do not mention here about gestational diabetes in which case the macrosomia is right and hypoglycemia could be excluded rightaway.The jitterines,lethargy and seizures can occour in most. This was my reasoning.Thanks a lot for your reply.
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