BATCH 23 MEDICAL UST #دفعة الدكتور حسن العريفي

السلام عليكم ورحمة الله. أمس بعد المراجعة تكلمنا مع الدكتور أحمد هُدنه عن مصادر المذاكرة وهل الملازم كافية أم لا ، قال ملازمكم تعتبر كافية لأنها إحنا بنأخذها من المرجع ، قلنا هل كافية لكل شي ولا لازم نذاكر من المرجع، قال كافية هو احنا أحياناً ندي أشياء من خارج ونلعب بالأسئلة وهكذا لكن بشكل عام الملازم وشرحنا كفاااااية.

Case discussion📢 History Ali, a 2-year-old boy, is referred to the paediatric day unit by his GP with a history of fever, cough, blocked runny nose and sticky eyes for 6 days. His GP prescribed amoxicil- lin 2 days ago for otitis media, and that evening he started to develop a rash around his ears and hairline. His parents stopped giving the antibiotics, but the rash continued to spread over most of his body. The parents report that he has been very miserable and lethargic for the last 5 days. They thought the rash may be an allergic reaction to amoxicillin. He attends nursery but his parents are not aware of any other children there who have been unwell. His parents are well, and he has an older brother who has autism. Examination Euan has a temperature of 38.5ЊC, his heart rate is 115 beats/min, respiratory rate 20/min, and oxygen saturation is 97 per cent in air. He weighs 14 kg (75th centile) and he is miserable and lethargic. He has a widespread maculopapular erythematous rash, which is coalescing over his face, neck and torso. Heart sounds are normal, capillary refill time is 2 s. There is no respiratory distress but he is coughing and there are lots of transmit- ted upper airway noises heard throughout his chest. His abdomen is normal. His nose is streaming with catarrh and he has a purulent discharge from his right ear. His pharynx is red and he has exudative conjunctivitis. Questions • What is the most likely diagnosis? • What essential piece of history has been omitted? • What complications may arise from this disease?

Answer Past history of pharyngitis Dark colored urine Puffy face Headache with vomiting ( hypertension) All these findings indicate Acute Poststreptococcal glomeronephritis

(A). Hematuria from within the glomerulus is often associated with urinary microscopic findings of RBC casts, and deformed urinary RBCs (particularly acanthocytes), brown, cola- or tea-colored, or burgundy urine, and proteinuria >100 mg/dLvia dipstick. Hematuria originating within the tubular system may be associated with the presence of leukocytes or renal tubular casts. Lower urinary tract sources of hematuria may be associated with gross hematuria that is bright red or pink, terminal hematuria (gross hematuria occurring at the end of the urine stream), blood clots, normal urinary RBC morphology, and minimal proteinuria on dipstick (<100 mg/dL).

(A). Mercury, lead, arsenic, and bismuth cause gum lines.