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    Case Discussion

    Uploaded by

    Punsalan Checa

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    © All Rights Reserved
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    Case Discussion

    Uploaded by

    Punsalan Checa
    9 views7 pages

    Original Title

    Ddx

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    Copyright:

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    Download as pptx, pdf, or txt
    9 views7 pages

    Case Discussion

    Uploaded by

    Punsalan Checa

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 7

    CASE DISCUSSION

    Approach to the Diagnosis

    Aspiration
    pneumonia
    Non infectious
    causes
    Hypersensitivity
    Clinical features of reaction
    suggestive of
    pneumonia
    Bronchiolitis Low Risk
    Infectious causes
    Community-
    Moderate Risk
    acquired

    High Risk
    RB | 1y4m | F | 8kg

    Salient Features
    SUBJECTIVES OBJECTIVES
    • 1y, 4m/F • Awake, active, irritable
    • (+) colds • Tachycardic (125bpm)
    • (+) cough, productive, clear sputum • Tachypneic (54cpm)
    • • Afebrile (36.7C)
    (+) fast breathing
    • Underweight
    • (+) difficulty of breathing
    • Stunted
    • (+) unrecalled vaccines given
    • (-) Cyanosis; Fair skin turgor
    • (-) grunting • (-) Sunken EB
    • Born full term • SCE, (+) occ. SC rets, (+) harsh BS with
    • (+)family exposure with cough & rales BLF
    colds • Fair equal pulses
    • (-) history of aspiration & toxic fume • CXR:
    inhalation • (+) infiltrates (lateral view)
    • (-)history of hypersensiivity reaction • (+)Hyperaerated
    • (+) lobar consolidation
    ASPIRATION PNEUMONIA
    RULE IN RULE OUT
    (-)Difficulty of breathing (-)foreign body
    (-)Tachypneic (54cpm) (-) post natal aspiration:
    (-)prematurity
    (-)gastroesophageal reflux
    (-)improper feeding practices
    (-)esophageal and duodenal
    obstruction
    (-) depressant medicines

    (+) occ. SC rets


    HYPERSENSITIVITY PNEUMONIA
    RULE IN RULE OUT
    (+)Difficulty of breathing (-)exposure to agricultural aerosols,
    animals and other chemicals (no
    antigen exposure)
    (+)Tachypneic (54cpm) (-) ground glass appearancce
    (+) occ. SC rets (-) lymphocytosis
    (+) rales (-) recurrent pneumoia
    (+) cough
    BRONCHIOLITIS
    RULE IN RULE OUT
    (+)Difficulty of breathing (-)toxic fume inhalation
    (+) undocumented fever fhptc (-)wheeze
    (-) cyanosis
    (+) good perfusion
    (-) history of post infection &
    connective tissuee disease
    (-) aspiration
    (+)Tachypneic (54cpm) CXR:
    (+) occ. SC rets (-) may be relatively normal
    (+) rales (-) hyperlucency (mosaic pattern)
    (+) cough
    COMMUNITY ACQUIRED PNEUMONIA
    RULE IN RULE OUT
    (+) <5 years old (-)history of aspiration
    (+)Difficulty of breathing
    (+)Tachypnea (54cpm) (-) cyanosis
    (+) occ. SC rets (-)lethargy,
    (+) rales (-) gastrointestinal disturbances
    (+) cough (vomiting, anorexia,
    (+) family exposure with cough and diarrhea)
    colds
    (+) elevated WBC
    CXR:
    (+) infiltrates (lateral view)
    (+)Hyperaerated
    (+) lobar consolidation

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