Case 19 - 7-month-old M with fever Flashcards
1
Q
Information gathering
A
CC Onset Fever Runny nose Ear pulling or discharge Cough, SOB SOB (breathing quickly) Difficulty breathing (flaring of nostrils, grunting or abdominal retractions ["belly breathing"]) Difficulty swallowing Rash N/V Change in bowel habits, color or consistency Change in urinary habits, smell or color (change in normal number of wet diapers) Shaking How has baby looked (lethargic, irritated, playful) Appetite changes Ill contacts Day care center Ill contacts at day care center Health maintenance (immunizations) Last checkup Birth Hx Child weight, height and language development Eating and sleeping habits PMHx PSHx Current medications Drug allergies
2
Q
Closure
A
I need to examine your child first.
In addition to a detailed physical exam, your baby may need some blood tests, a urinalysis and a CXR.
Do you have any questions for me?
3
Q
Differential diagnosis
A
Viral URI
PNA
Otitis media
4
Q
Diagnostic work-up
A
CBC with differential Blood culture UA and urine culture CXR Respiratory viral panel Pneumatic otoscopy LP - CSF analysis
