PBL NEC

Views:
 
Category: Entertainment
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

slide 1:

Tutor Guide Goal Management of NEC Objective Definition of Terms Epidemiology of NEC Cause of NEC Patho-physiology of NEC Clinical manifestations of NEC Complication of NEC Prevention of NEC Contents to be included Anatomy physiology Parasitology pharmacology fundamental Neonatal Part one Objective Define terms vomiting diarrhea feeding intolerance and abdominal distention Can cocaine harm the infant How Part Two Objective What are the possible problems Why Part Three Objective What are the abnormal Physical findings Relate with previous problem What are the possible problems Why Part Four Objective What are the abnormal lab findings What they suggest What is the child main problem How can manage this problem

slide 2:

PARTE ONE Triggering Problem: Baby “M” was 3kg male infant born to a 26 year old woman. Mr. M comes with vomiting diarrhea feeding intolerance and abdominal distention. The mother use cocaine for recreational purpose.

slide 3:

PART TWO This 3kg baby was delivered at term from cocaine user women 3 days before spontaneously through vaginal. The child has taken breast feeding and additional butter since 2 days later. Currently the child has vomiting which is non-projectile aggravated through breast feeding. Similarly the child has also diarrhea which is blood stained sometimes is it tarry stool. The child abdomen is distended but the mother said “I had no foul smelling vaginal discharge during pregnancy.” She has attended the first two ANC follow up and she lives in urban area. Her educational status is college level. The mother has no past medical problems such as HTN DM and CHF.

slide 4:

Part Three Physical Examination General Appearance: Acute sick looking with lethargy V/S: T: 36.5 o c RR: 55 PR: 136 PO 2 : 92 Anthropometry: Wt: 3kg Length: 48cm HC: 32 cm HEENT: No molding pink conjunctiva no eye discharge no redness patent nostril no buldging fontanel no cleft lip and palate dry oral mucosa Chest He has regular breathing pattern No grunting no strider have chest indrowing S1 and S2 are well heard no bulged pericardium symmetric chest movement no gallop no murmur Abdomen No umbilical discharge secure cord tie No visible abdominal defects and perforated anus but the child has decrease bowl sound withVisible distended abdomen and tender palpable abdominal mass Erethema of abdominal wall Gastric aspirates increased in volume and were blood tinged GUS White vaginal discharge labia majora not fully cover labia minora no ambiguous genitalia Integumentary No skin pustule no redness yellowish discoloration of face bluish discoloration on palm but pink other bodies gelatinous skin MSS Partial flexed hip and knee no clubfoot Neurological examination Complete moro reflex week rooting reflex weak sucking reflex no NTD

slide 5:

PART FOUR CBC: Hg 12mg/dl Hct: 36 similarly CBC shows leucopenia and thrombocytopenia100000 absolute neutrophil count 992 after 2 days he had worsening neutropenia ANC 360 with eosinophilia12 and monocytosis 24. His abdominal films showed pneumatosis intestinalis bowel wall thickening and progression to left-sided pneumatosis BGL: 40mg/dl Na 130 mEq/L CSF: protein 60mg/dl Glucose 50gm/dl WBC count 19cells/mm 3 TBL: 7mg/dl Blood culture: Negative 1 st day after 10 days After 15 days PART FOUR CBC: Hg 12mg/dl Hct: 36 similarly CBC shows leucopenia and thrombocytopenia100000 absolute neutrophil count 992 after 2 days he had worsening neutropenia ANC 360 with eosinophilia12 and monocytosis 24. His abdominal films showed pneumatosis intestinalis bowel wall thickening and progression to left-sided pneumatosis BGL: 40mg/dl Na 130 mEq/L CSF: protein 60mg/dl Glucose 50gm/dl WBC count 19cells/mm 3 TBL: 7mg/dl Blood culture: Negative 1 st day after 10 days After 15 days PART FOUR CBC: Hg 12mg/dl Hct: 36 similarly CBC shows leucopenia and thrombocytopenia100000 absolute neutrophil count 992 after 2 days he had worsening neutropenia ANC 360 with eosinophilia12 and monocytosis 24. His abdominal films showed pneumatosis intestinalis bowel wall thickening and progression to left-sided pneumatosis BGL: 40mg/dl Na 130 mEq/L CSF: protein 60mg/dl Glucose 50gm/dl WBC count 19cells/mm 3 TBL: 7mg/dl Blood culture: Negative 1 st day after 10 days After 15 days

authorStream Live Help