common clinical presentations exam with complete accurate answers.
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Course
USMLE
Institution
USMLE
A 52-year-old man comes to the physician complaining of dizziness, headaches, and pruritus after showering. He has smoked half a pack of cigarettes daily for the past fifteen years and drinks alcohol socially. Physical examination shows a reddish facial complexion and mild splenomegaly - Answer Pol...
POLIE 1 - Common presentations questions with
complete accurate answers.
Causes not to be missed for respiratory distress in a neonate? - Answer
Causes not to be missed
Common causes of resp. distress in a neonate? - Answer Common
causes
Transient tachypnoea of the newborn
Respiratory distress syndrome due to hyaline membrane disease
Sepsis
Recall that clinical signs of sepsis can be subtle and non-specific. What
are some of the signs to look out for? - Answer Signs may include one or
more of the following:
respiratory distress
temperature instability
poor peripheral perfusion
unexpected need for resuscitation
apnoeic episodes
How would you assess a neonate in resp. distress? - Answer Here are
some aspects of examination that are important in a neonate with
respiratory distress.
Assess for signs and severity of respiratory distress:
-Effort: Respiratory rate, grunting, recession, nasal flare, head bobbing
- Efficacy: Chest expansion, breath sounds, oxygen saturations
-Effect: Heart rate, skin colour, mental state
Listen for air entry: present, symmetrical
Cardiovascular examination: murmurs, hepatomegaly, pulse volume
Other signs of infection: fever, rash, level of consciousness, poor tone,
malodour
Signs of other congenital lesions
What is the clinical exam for hip dysplasia in infants? - Answer Clinical
hip examination is recommended in all infants at birth, 2--6 weeks of
age, and until a mature gait is established at 18 - 24 months of life. In
the first three months of life, joint instability is the most likely
presentation. This is elicited using Barlow and Ortolani manoeuverres.
The Barlow test attempts to dislocate a hip posteriorally, while the
Ortolani test aims to relocate a dislocated hip. Asymmetric leg creases,
or apparent shortening of one femur may also suggest the diagnosis.
,What information do you want before assessing a baby for a neonatal
check? - Answer ::Mother
age
previous children/pregnancies—any issues
any difficulties during this pregnancy
serology
blood group
Group B Strep status if known
delivery
mode of delivery
time of rupture of membranes, antibiotics
maternal fever
Apgars of baby at birth
any resuscitation required
::Baby
age now in hours
blood group, direct antiglobulin test (DAT) from cord blood (if done)
birth weight, any subsequent weights
feeding
urine/meconium
observations
HepB/VitK given
What are common and serious causes of jaundice in a neonate (48
hours)? - Answer ::Common causes of jaundice at 48 hours of age
, Physiological jaundice
Breastfeeding (establishment) jaundice (develops within 2-4 days of
birth; infrequent breastfeeding with limited fluid intake and increased
reabsorption of bilirubin from the bowel)
Breakdown of extravasated blood (cephalohaematoma)
::Causes of neonatal jaundice not to be missed
Haemolysis (Rhesus disease, ABO incompatibility, other blood group
incompatibilities)
Red cell enzyme defects (G6PD deficiency)
Red cell membrane defects (spherocytosis)
Sepsis
Polycythaemia
What are some causes of jaundice in a 10 day old infant? - Answer By
10 days of age, most babies have established feeding and are passing
stools regularly. The time for physiological jaundice has passed. From
this age we are more likely to see the presentation of conjugated
hyperbilirubinaemia. The differential diagnosis thus includes:
breast milk jaundice- late breast milk jaundice is much less common
and develops 4-7 days after birth with a peak at 7-15 days of age
conjugated hyperbilirubinaemia due to:
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