so you think you could be an MD?

[DoubleDown]

always see people posting various ailments, illnesses, and diseases they think they might have. here are a few clinical case scenarios for you medical detectives out there.

1 - A 4-year-old boy presents with a five-day history of fever and rash. He has received acetaminophen and amoxicillin without improvement. He is very irritable with a temperature of 103.6� F, bilateral non-purulent conjunctivitis, enlarged cervical nodes, puffy hands, and a maculopapular rash. How would you evaluate and manage this patient?

2 - An eight-year-old female presents with abdominal pain, pruritic lesions on the buttocks and lower extremities, and joint swelling. What is your differential diagnosis? How would you evaluate this patient?

3 - A six-year-old boy presents with pallor and irritability following a week of abdominal pain and blood tinged diarrheal stools. What would you be most concerned about? How would you evaluate and manage this patient?

[Lazymeatball]

they all have AIDS

Amputate. All three of them.

[7ontheline]

What is this, USMLE Step 3?

That reminds me, I gotta start studying for that. Damn ophthalmology, I forgot all my internal medicine stuff over the last 3 years.

[Los Feliz Slim]

1. It's too late for him now. Euthanasia.

2. This girl has been abused and needs to be moved into foster care.

3. This boy is abusing performance enhancing drugs, most likely anabolic steroids. This is important, because he is probably quick with the punching, and very strong of course. So, security must be called to restrain him. Then, get him into counselling so he can return after his suspension.

[DoubleDown]

7- theyre vignettes for a 3rd yr peds rotations

others- great responses so far, keep em comin

[adamstewart]

For each patient:


Are they stable or unstable? What are their vitals?

What are their past medical histories? What medications are they on?

What is the history of present illness? (i.e. describe the events, signs, and symptoms that have led to the patient's presentation today ...)

We'll also need complete 'Review of Systems' from head to toe.

Are there any illnesses that run in the family?


Adam

[BeerMoney]

1.) Have his mother blow me.

2.) Anal with her mom.

3.) Anal with his mom.

[DoubleDown]

Adam- there is no add'l info to be offered. pts are stable, the main issues and pertinent +'s and -'s are in the 2-liner.

Beer$- not worried that any of these kids could be suffering from an STD passed on by mom? just be sure to dbl-bag it at least

[Mason Hellmuth]

DoubleDown,

You can't get STDs from anal.

Expertly yours,
Mason Hellmuth

[DoubleDown]

Expert,

maybe my sarcasm filter is malfunctioning, but ummmmm... yes, you can.

unexpertly yours,
DD

[garion888]

I think they are all candidates for post-third trimester abortion.

PS: I never thought I could be an MD...you proved me wrong. I know this prognosis is correct.

[HopeydaFish]

[ QUOTE ]

2 - An eight-year-old female presents with abdominal pain, pruritic lesions on the buttocks

[/ QUOTE ]

That's so hot.

[Glenn]

1. Sounds like he has measles. So isolate him, vaccinate anyone he's been in contact with that's never had it, and manage his symptoms.

2. Rheumatic fever? The joint swelling made me think that right away but I'd need way more info to make that determination. Either you left out a bunch of symptoms or I am completely off base here. I would ask if the child had a sore throat within the past month or so at least...

3. This is not nearly enough information. You basically just try and get him hydrated and treat his symptoms to maybe get some nutrients in his body. Take a history to try and find out what caused this (like have you been out of the country, etc). That will give you a better idea where to start looking (parasite, virus, etc). The blood in the stool means it's reasonably serious, but that's about all you can get from that info. Need to run some blood tests and take a stool sample to know where the blood is coming from and how much he is losing.

[MrX]

[ QUOTE ]


1 - A 4-year-old boy presents with a five-day history of fever and rash. He has received acetaminophen and amoxicillin without improvement. He is very irritable with a temperature of 103.6� F, bilateral non-purulent conjunctivitis, enlarged cervical nodes, puffy hands, and a maculopapular rash. How would you evaluate and manage this patient?



[/ QUOTE ]

This kid has sequelae of an accident, probably hit by a Kawasaki.

X

[garion888]

Alright my last post was in jest. The first kid looks like he has kawasaki disease although he's a little old for it.

[Glenn]

damnit you're right i just ignored the swollen hands /images/graemlins/smile.gif.

[garion888]

Number 2's got Henoch-Schonlein Purpura.

[garion888]

Number 3 looks like colitis caused by E. Coli poisoning. Clean up the house dammit.

[DoubleDown]

X: nice work on #1

[masse75]

clearly, the diagnosis is that the OP is a moron.

[Cancuk]

If you think you are so smart, diagonis this dandy:

A 22 year old male comes into the hospital. His stomach is killing him and he hasn't taken a sh.it in a week. His stomach is also starting to sweel a little bit.
What your diagnosis doc?

[garion888]

Looking for a little free medical advice?

[DoubleDown]

gar- he doesnt need free med advice. he's a canuck - he gets free med CARE

[garion888]

yeah as long as its not teeth or eyes...so how'd I do on number 2 and 3?

[swede123]

1 - Not too old for Kawasaki's Disease, 80% are less than age 5. Recommend therapy with IVIG, and high dose aspirin. This will decrease the incidence of corronary artery dilation and aneurysm formation.

Swede

[garion888]

I thought it was two...oh well...

[chuddo]

1. shark attack
2. glaucoma
3. homosexuality

how did i do?

[swede123]

2 - Probably Henoch-Schönlein purpura. Would want to see a UA looking for gross hematuria, since this causes IgA deposition in the kidneys, as well as the rash, abdominal pain and arthritis described in the case.

Swede

[ QUOTE ]
If you think you are so smart, diagonis this dandy:

A 22 year old male comes into the hospital. His stomach is killing him and he hasn't taken a sh.it in a week. His stomach is also starting to sweel a little bit.
What your diagnosis doc?

[/ QUOTE ]

To much butter.

[PoBoy321]

Here's one for you. A 16 year old boy comes in at 3am with a dog bite to his genitals. What's your move, hotshot?

<font color="white"> I was in a hospital emergency room, and there really was a kid in there who this happened to. </font>

[Mvcode3]

Shoot the hostage

[dizong]

booooo, i don't like pediatrics

[TimM]

[ QUOTE ]
Here's one for you. A 16 year old boy comes in at 3am with a dog bite to his genitals. What's your move, hotshot?

[/ QUOTE ]

Take away his peanut butter.

[Russ McGinley]

This thread desperately needs a House gimmick account.

[astroglide]

russ,
when people ask for gimmick accounts they always end up sucking

[Russ McGinley]

But House can answer all the questions and insult you at the same time. It can't miss!

[Warik]

[ QUOTE ]
1 - A 4-year-old boy presents...

2 - An eight-year-old female presents...

3 - A six-year-old boy presents...

[/ QUOTE ]

http://www.smh.com.au/ffximage/2005/07/08/hughlaurie_narrowweb__200x272.jpg


"Do an MRI."

[ChuckyB]

[ QUOTE ]
1 - A 4-year-old boy presents with a five-day history of fever and rash. He has received acetaminophen and amoxicillin without improvement. He is very irritable with a temperature of 103.6� F, bilateral non-purulent conjunctivitis, enlarged cervical nodes, puffy hands, and a maculopapular rash. How would you evaluate and manage this patient?

[/ QUOTE ]

Robitussin

[ QUOTE ]
2 - An eight-year-old female presents with abdominal pain, pruritic lesions on the buttocks and lower extremities, and joint swelling. What is your differential diagnosis? How would you evaluate this patient?

[/ QUOTE ]

Robitussin

[ QUOTE ]
3 - A six-year-old boy presents with pallor and irritability following a week of abdominal pain and blood tinged diarrheal stools. What would you be most concerned about? How would you evaluate and manage this patient?

[/ QUOTE ]

Anal probe with Robitussin

[Redd]

[ QUOTE ]
If you think you are so smart, diagonis this dandy:

A 22 year old male comes into the hospital. His stomach is killing him and he hasn't taken a sh.it in a week. His stomach is also starting to sweel a little bit.
What your diagnosis doc?

[/ QUOTE ]

I'd tell him to take a sh!t.

[Warik]

[ QUOTE ]
I'd tell him to take a sh!t.

[/ QUOTE ]

Congratulations... you just killed your patient!

[slamdunkpro]

Not an MD but my wife is a Equine Vet so I asked her:

1. Shoot 'Em

2. Shoot 'Em

3. Shoot 'Em

[Cancuk]

[ QUOTE ]
[ QUOTE ]
If you think you are so smart, diagonis this dandy:

A 22 year old male comes into the hospital. His stomach is killing him and he hasn't taken a sh.it in a week. His stomach is also starting to sweel a little bit.
What your diagnosis doc?

[/ QUOTE ]

I'd tell him to take a sh!t.

[/ QUOTE ]

The correct answer, of course, is that he ate a large rock.

[diebitter]

[ QUOTE ]
If you think you are so smart, diagonis this dandy:

A 22 year old male comes into the hospital. His stomach is killing him and he hasn't taken a sh.it in a week. His stomach is also starting to sweel a little bit.
What your diagnosis doc?

[/ QUOTE ]

Has he recently had a xenomorph attached to his face with an athropod/crustacean-looking appearance and a large muscular tail?

[Punker]

Leeches.