100 Cases in Paediatrics by Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph

By Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph Raine, Joanna Walker

The recent version of this best-selling name from the preferred a hundred circumstances sequence explores universal paediatric situations that would be encountered by means of the clinical scholar and junior health care provider in the course of functional education at the ward, within the emergency division, in outpatient clinics and in the neighborhood, and that are prone to characteristic in qualifying examinations. The ebook covers a accomplished variety of shows from cough to constipation, equipped via sub-specialty quarter for ease of reference. finished solutions spotlight key take domestic issues from each one case and supply useful suggestion on how you can care for the demanding situations that ensue while practicing paediatric medication in any respect degrees.

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These features are consistent with the clinical diagnosis of pneumonia. The combination of clubbing and recurrent chest infections is strongly suggestive of cystic fibrosis (CF). This is the commonest cause of clubbing in children in the UK. Normal immunoglobulins exclude antibody deficiencies such as X-linked hypogammaglobulinaemia. Malabsorption (with bulky, offensive stools) is another common feature of CF. Cystic fibrosis is an autosomal recessive condition affecting 1 in 2500 children born in the UK.

There is a family history of hypertension and his grandfather died of a myocardial infarction a year ago. Examination His pulse is 86/min, regular, his blood pressure is 124/82 mmHg and his heart sounds are normal. There is no hepatomegaly. Femoral pulses are palpable and his chest is clear. 62 m, PEFR range 320–570 L/min). On palpation there is no chest tenderness. INVESTIGATIONS His ECG and chest X-ray are both normal. Questions • What is the most likely diagnosis and the differential diagnosis?

In SIADH, urine osmolality is inappropriately high (Ͼ320 mosmol/kg) and urine sodium is usually Ͼ40 mmol/L (unlike hypovolaemic states where it is Ͻ20 mmol/L). g. co-amoxiclav Initial fluid restriction to two-thirds maintenance to help correct the hyponatraemia. Fluid restrict even if no hyponatraemia, as SIADH may still develop Fluid balance, regular urea and electrolytes – adjust fluids accordingly. g. bubble blowing. Encourage mobility Monitor for development of a pleural effusion. If the chest X-ray is suspicious, an ultrasound will be diagnostic.

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