1.+What are the main symptoms found on this patient?- According to the patient's history and presentations, what are the probable issues that you will need to think of?
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- A fever is considered to be a ____________________________. prognosis sign symptom syndromeLin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. He visited a local hospital and-underwent a blood routine test: WBC=8.7X10°L, N=21%, RBC= 3.36X10%/L, BPC=75X 10°/L, Hb=109g/L; peripheral -blood smear shows: atypical cells 29%. The local hospital suspected "infectious mononucleosis", thus intravenous ganciclovir was given and his blood was extracted to check for anti-EBV antibody simultaneously. After 6-days of intravenous ganciclovir, his body temperature still fluctuated at around: 38°C. Anti-EBVVCA-IgM(-), anti-VCA-IgG(+) 1. Do you think the doctor's diagnosis is correct? And what do you think the next step would the doctor take? 2. How long does a normal fever and infectious fever last?Lin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral- temperature of- 40°C, no obvious cough, runny nose, vomiting, headache, dizziness, melena, urinary frequency, urgency, and dysuria but had nose bleeding. In the first hospital, he was suspected to have EBV infection and "infectious mononucleosis". He was given intravenous ganciclovir at first. However, Lin's oral temperature still fluctuated at around 38.5°C after the regimen and complained of weakness, significant headache, and bilateral elbow joints pain. He then visited another outpatient clinic of a pediatric hospital, and physical examination in the department shows: well physical development, conscious, steady breathing, well mental response, no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness but…
- A 62-year-old male, his back has been red and swelling for 1 week. At first it was a small piece of skin induration of about 3×2cm, with multiple pus spots, then the skin swelling area expanded, infiltrating edema appeared, local pain increased, the surface skin was purple-brown with area about 6×5cm, the body temperature was 39.2℃, and he had diabetes history for 10+ years. The following treatment measures are incorrect for this patient: Remove pus and inactivated tissue The incision line should exceed the edge of the lesion The incision can be filled with yarn One-stage suture of the incision Make a "++" incisiona 58-year-old Asian male .He visited his physician because he noticed dark colored lesions on his inner thighs, have increased in number, size. For the last three months he has been feeling weaker and more fatigued than usual; his weight dropped from 170 to 155 pounds. Xin’s blood was drawn and testing was conducted. His hematocrit was 45% and white-blood cell count was 2,500 white-blood cells/mm3, with the differential showing neutrophils 65%, lymphocytes 25%, monocytes 10%. A biopsy was taken of one of the discolored lesions and grown in cell culture. After three days of growth the cells were confirmed as coming from malignant cancerous tissue. A magnetic resonance image (MRI) of the area around the skin lesions on Xin’s inner thigh revealed enlarged lymph nodes, a sign of potential metastasis. What possible Diagnosis or disorders can you rule out for this paitentLin, a 5-year-11-month-boy, had a fever 20 days ago with no obvious trigger and reached the highest oral temperature of 40°C. He visited 2 pediatric hospitals and the results are as follows. 1st hospital Blood routine test: WBC: 8.7 X10°/L, N: 21%, RBC: 3.36X10°/L, BPC: 75X 10/L, Hb: 109g/L; peripheral blood smear shows: atypical cells 29%. Suspected "infectious mononucleosis" and EBV infection, thus intravenous ganciclovir was given. 2nd hospital No anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). The liver and spleen was palpable 1.0cm below rib with a soft texture, tenderness (-) and rebounds tenderness (-). All joints had no swollen and tenderness. Blood routine test: WBC: 7.2 X 10°/L, RBC: 3.1 X 10°/L, BPC: 64 X 10°/L, Hb: 90g/L, atypical cells 7%. Peripheral blood smear test: blast=18%, L=48%, N=31%. 1. Are liver and spleen palpable in child if there is no hepatosplenomegaly? 2. Why did the 1t hospital doesn't do the liver,…
- Female, 26 years old, married. Abdominal pain, diarrhea, fever, vomiting for 20 hours After 24 hours of eating, the patient developed abdominal discomfort, paroxysmal with nausea, vomiting stomach contents, fever and diarrhea several times, loose stools, no pus and blood, body temperature 37-38.5°C, come to our hospital for emergency, the routine test of stool was negative. She was treated according to "acute gastroenteritis". The abdominal pain worsened in the evening, accompanied by fever of 38.6°C. Then, the abdominal pain moved from the stomach to the right lower abdomen, and there was still diarrhea, she come to see a doctor again at night, check blood routine WBC21×10%/L, and be admitted to the hospital urgently. Previous history: healthy, no history of drug allergy. Physical examination: T38.7°C, P120/min, BP 100/70mmHg, no bleeding spots and rashes on the skin all over the body, no large superficial lymph nodes, no pallor of the conjunctiva, no yellow staining of the sclera,…Female patient whose is a 13-year-old, was admitted to the hospital with complaints of progressive weakness and shortness of breath with minimal physical effort. She has experienced recurrent fevers reaching 38.8°C. Physical examination reveals a well developed teenage with good nutritional status and in no acute distress. There is no lymphadenopathy or organomegaly. Many petechial hemorrhages cover her chest and legs. Several bruises are found on her legs and thighs. Laboratory tests were ordered upon admission. The laboratory tests result were as the following: RBC 2.24 X1012 /l Hb 71 g/l PCV 24% Plt 8.0 X109/l WBC 1.2 X109/l Differential Segmented Neutrophils 2% Lymphocytes 94% Monocytes 4% Reticulocyte count 0.7% She was referred to a hematologist who ordered a bone marrow examination. Bone marrow biopsy showed a markedly hypocellular marrow with very few hematopoietic cells and…Female patient whose is a 13-year-old, was admitted to the hospital with complaints of progressive weakness and shortness of breath with minimal physical effort. She has experienced recurrent fevers reaching 38.8°C. Physical examination reveals a well developed teenage with good nutritional status and in no acute distress. There is no lymphadenopathy or organomegaly. Many petechial hemorrhages cover her chest and legs. Several bruises are found on her legs and thighs. Laboratory tests were ordered upon admission. The laboratory tests result were as the following: RBC 2.24 X1012 /1 Hb 71 g/l 24% 8.0 X10/1 PCV Plt WBC 1.2 X109/1 Differential Segmented Neutrophils Lymphocytes Monocytes Reticulocyte count 2% 94% 4% 0.7% She was referred to a hematologist who ordered a bone marrow examination. Bone marrow biopsy showed a markedly hypocellular marrow with very few hematopoietic cells and there were no malignant cells present. 1- Connect these clinical symptoms with her laboratory-screening…
- Lin, a 5-year-11-month-boy. He-had a fever 20 days ago with no obvious trigger and reached the highest oral-temperature of- 40°C, he was suspected "infectious mononucleosis", thus intravenous ganciclovir was given and his blood was extracted to check for anti-EBV antibody simultaneously. After 6-days of intravenous ganciclovir, his body temperature still fluctuated at around: 38°C. Anti-EBVVCA-IgM(-), anti-VCA-IgG(+) The physician stopped intravenous ganciclovir and gave a one-week oral antivirus drug regimen and told the parents to come back for the blood routine and blood smear after a week. However, Lin's oral temperature still fluctuated at around 38.5°C after the regimen and complained of weakness, significant headache, and bilateral elbow joints pain. 1. Does changing intravenous to oral antiviral drug mean that this patient is recovering? 2. What would you do if you were the patient's parent?24-year-old male, drug user (marijuana) and hookah user, he comes to the emergency room with a chronic, productive cough, a viscous sputum, and a loss of approx. 15 lbs of weight. Then he started with dyspnea when walking, stabbing pain in right chest, night sweats. He denies quantified fever spikes. RT: 120-80Mmg, FC 80latxmts, FR: 16, SATO2 98%. Symmetric chest, Lungs: absence of vesicular murmur in the lower 2¨ thirds of the right hemithorax, and dullness in this area, no added noises or rales. a) Possible diagnoses b) What studies would you request from this patient. c) Treatments according to your diagnostic approaches.A 38-year-old woman came in the outpatient department because of headache.She has no vomiting, fever, changes in sensorium and nuchal rigidity. Shedescribed the headache as ”band-like” and has been occurring intermittentlyespecially during stressful situations. Vital signs and physical examinations areall normal. The physician diagnosed her as having tension headache andprescribed Acetaminophen 1g/ tab PO q6H for 3 days. The pharmacy only hasthe 250mg tablet preparation. How many tablets does she need to take perdose? How many tablets should the pharmacist give her to complete the entiretreatment regimen?
