Patient 1: 3 month old, afraid swallowed something, was soon chocking, father gave Heimlich with no result.
Chest xray big heart, second one wanted
No arrhythmia
130 bpm
Give bronchoscopy
Patient 2: Teen girl pain in right lower quaderant
Rule out appendisitis
Us negative
OBGYN- maybe ovulation.
Pain gone- discharged
Patient 3: 6 yr old with SVT
Had attack
Treat with tighten stomach muscles and make noise to stimulate parasympathetic nervous system
Patient 4: Infant ate 6-7iron pills 30mg/kilo
9-10 pm ate pills and ate and behaved normal, called poison control after vomiting at 12am, pediatric department in morning.
PE hemodynamically stable
Observation due to blood gas-metabolic acidosis- ph 7.368 p02 38.6 potassium 5 (high due to transporter in tubules exrering hydrogen ions in exchange for k ions)
Patient 5: baby unexplained fever and slightly leukopenic
Total septic workup: LP normal
Chest xray big heart, second one wanted
No arrhythmia
130 bpm
Give bronchoscopy
Patient 2: Teen girl pain in right lower quaderant
Rule out appendisitis
Us negative
OBGYN- maybe ovulation.
Pain gone- discharged
Patient 3: 6 yr old with SVT
Had attack
Treat with tighten stomach muscles and make noise to stimulate parasympathetic nervous system
Patient 4: Infant ate 6-7iron pills 30mg/kilo
9-10 pm ate pills and ate and behaved normal, called poison control after vomiting at 12am, pediatric department in morning.
PE hemodynamically stable
Observation due to blood gas-metabolic acidosis- ph 7.368 p02 38.6 potassium 5 (high due to transporter in tubules exrering hydrogen ions in exchange for k ions)
Patient 5: baby unexplained fever and slightly leukopenic
Total septic workup: LP normal
Gave antibiotics for gram negative ecoli and bacteria
Watch 10 hrs, baby appears ok
Watch 10 hrs, baby appears ok
Patient 6: neonatal with fever
Any risk factors for sepsis? 1) maternal fever 2) prolonged water broken over 24 hrs 3) mother is a GBS carrier
Can give sucrose for mild sedation for urinary catheter and blood workup
Patient 7: 16 yr old female hyperglycemia-Type I Diabetes juvenile onset.
DD: stress due to release of cortisol, Blood glucose levels can be seen as high as 300
Symptom: weakness, no polydipsia, no polyuria no weight loss.
Treat with Insulin and watch her for first few hours to get the dosage right. 0.7-1 unit/kg/day
Patient 8: fever with small spotted rash over body
Could be CBC enteroviral rash.
Patient 9 (I assessed patient-history,PE): 14 yr old female RLQ pain and fever 101F/ 38.3C for 1 week.
Can not eat or drink without vomiting for a week, increased pain while bending over. Normal bowl movements, no diarrhea, no constipation.
Second time admitted, first time US came clear, Gynecological exam and US clear, PE good, no hepatomegaly, no spleenomegaly.
Blood work done and another US to check appendicitis.
IV fluids given to rehydrate
Patient 10: Generalized seizure possibly tonic clonic (grand mal)
Give 02
Volunteer in Hospital: I inserted an IV into a volunteer and into a soon to be new doctor for practice.
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