Pediatrics

Download e-book for iPad: 100 Cases in Paediatrics by Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph

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

ISBN-10: 0340968753

ISBN-13: 9780340968758

The hot version of this best-selling name from the preferred a hundred situations sequence explores universal paediatric situations that would be encountered via the clinical scholar and junior health practitioner in the course of sensible education at the ward, within the emergency division, in outpatient clinics and in the neighborhood, and that are prone to function in qualifying examinations. The publication covers a finished variety of shows from cough to constipation, prepared via sub-specialty quarter for ease of reference. accomplished solutions spotlight key take domestic issues from each one case and supply sensible recommendation on tips to take care of the demanding situations that happen while working towards paediatric medication in any respect degrees.

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First, the result should be confirmed – taking blood from children can be difficult and unexpected results should be repeated. At the same time, urine should be sent for osmolality and sodium. His serum osmolality is calculated as follows: 2 ϫ ([Na] ϩ [K]) ϩ [urea] ϩ [glucose] ϭ 266 mosmol/kg (normal 278–305) Normally a fall in serum osmolality would suppress antidiuretic hormone secretion to allow excretion of excess water as dilute urine. 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).

These two parallel circulations would result in the vital organs never receiving oxygenated blood, and hence rapid death, if it was not for mixing in the atria via the foramen ovale and between the aorta and pulmonary arteries via the ductus arteriosus. Chest X-ray may show a narrowed upper mediastinum due to the abnormal position of the aorta and pulmonary arteries. Echocardiography by an experienced operator is necessary to confirm the diagnosis. The hyperoxia test provides a means of diagnosing whether cyanosis is due to cardiac or respiratory disease.

There is no hepatosplenomegaly. 0 kPa Questions • What is the likely diagnosis and differential diagnosis? • How do you interpret the blood gas results? • What is the emergency management? 29 100 Cases in Paediatrics ANSWER 9 This baby is most likely to have transposition of the great arteries. There are few congenital cyanotic heart conditions that present on the first day of life, because in most cases the ductus arteriosus remains open at this stage, maintaining pulmonary blood flow in conditions such as pulmonary and tricuspid atresia where pulmonary blood flow would be severely restricted or absent.

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


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