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general aspect :9 months old boy with tachypnea ,chest wheezes and splenomegaly
he has ahistory of congenital heart disease:acontinuous murmur is heard below left clavicle and
interscapular area
bilateral coarse bubbling crepitations also present
questions
the first step in management is :choose
blood culture
penicillin
echo
the best of ttt of chest wheezes include :choose
antibiotics
digitalis
steroids
الاشتراك في:
تعليقات الرسالة (Atom)
هناك 8 تعليقات:
the first step in management is
echo
the best of ttt of chest wheezes include
steroid
ربنا يستر
منتظره باقي الحالات
اهو الواحد بيراجع لحسن انا شكلي نسيت كل حاجه والله
شكرا د/شادي
سالي
انا شايف
penicillin
digitalis
السلام عليكم
اعتقدالاول هديله
penicillin
والتانى
steroids
انا شايف
السؤال الأول echo
والسؤال التانى
degitalis
طبعا انا عندى تفسير للى قلته
بس انت مطلبتهوش
لو مشيت على النمط دا تبقى تمام
تحياتى
the first step is penicillin IV as the case is CHD mostly patent
ductus arteriosus
complicated by bronchopneumonia so i must first give antibiotic then do echo and blood culture to confirm my diagnosis
THE BEST TTT of wheeze in this case is antibiotic as ttt of broncho pneumoni we donot need to give bronchodilators and steriod is contraindicated.digitalis is used for heart failure which hepatomegaly is the constant sign and u didnot comment on liver and also crepitation of heart failure is fine not coarse so i excude heart failure
I SUSPECT IEC DUE TO SPLENOMEGALY
THUS
1ST STEP IN MANAGMENT WILL BE
BLOOD CULTURE
the best of ttt of chest wheezes include
antibiotics
penicillin
antibiotics
كله اطفال اطفال.. مافيش حالات باطنة ينوبك ثواب؟؟؟
حلم كبير
بسم الله الرحمن الرحيم
im extremely happy
im not qualified to judge my beautiful minded colleages
هذه الحاله كان معنا لمناقشتها الدكتور اسامه عبد رب الرسول ولم يكتشف تضخم الطحال الا فى الراوند والدكتور اسامه قال ان الحاله هتطلع العنايه لاشتباه IEC
there was chest wheezes but i added bubbling crepitations to exclude pneumonia bubbling crepitations indicate HF
DR/Osama said it is acase of PDA complicated by IEC & cardiac asthma (clinically) im sorry for all these لخبطه
but im on the way so plz give me more time
so, the first step in managment will be empiric antibiotics then culture but, if the case will be referred the first is penicillin then blood culture in the hospital and penicillinase will be added
the best ttt for left sided heart failure (cardiac asthma) is digitallis
no evidence of pneumonia so no antibiotic in that question
and steroids are not helpful in non inflammatory bese
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