BATCH 23 MEDICAL UST #دفعة الدكتور حسن العريفي

السلام عليكم. الذي معه الملفات الأصلية لمحاضرات emergency تبع الدكتور أحمد هدنه الذي نفس هذه ، ممكن يتفضل يراسلنا عبر #بوت_التواصل👇👇👇👇 T.me/UST2017_bot

#منشور_مؤقت السلام عليكم ورحمة الله الزملاء الأعزاء اللي حاب ينزل ال History taking تبع الباطنه او تبع اي Branch سوى أطفال او نسائية او حتى جراحه ويخليه صدقه جاريه له يتفضل ويرسله لنا وسيتم انزاله كمرجعيه للطلاب T.me/UST2017_bot وشاكرين حسن تعاونكم معانا... 🌸

ANSWER This is a case of measles. The history is typical, commencing with a catarrhal prodrome phase of fever, conjunctivitis, cough and coryza, preceding development of the rash 3–5 days later. During the catarrhal phase, Koplik’s spots may be seen as small white spots on the buccal mucosa. Although pathognomonic of measles, they can be very hard to find and have usually disappeared within 1 day of the rash starting. The rash is maculo- papular and starts around the hairline and behind the ears, spreading downwards across the body. It often becomes confluent on the upper body, resulting in a blotchy appear- ance. Usually children with measles are very miserable. ! Differential diagnosis of measles Clinical distinguishing features Kawasaki disease Not catarrhal Rubella Much milder prodrome, occipital lymphadenopathy Epstein–Barr virus Tonsillitis, lymphadenopathy, not catarrhal Roseola infantum (human herpes Fever ends as rash appears virus 6, HHV6) Scarlet fever Pharyngitis or tonsillitis, not catarrhal An immunization history is an essential part of any paediatric history and no details have been provided here. In fact, Euan had not received the combined measles, mumps and rubella (MMR) vaccine, which is usually given at 13 months of age. ! Complications of measles • Pneumonia • Corneal ulceration • Suppurative otitis media • Gastroenteritis • Febrile convulsions • Encephalomyelitis (rare) and subacute sclerosing panencephalitis (very rare) Public confidence and uptake of the MMR vaccine fell in the UK following media pub- licity about a study in 1998 suggesting a link between the vaccine and autism. Despite many publications demonstrating the safety of MMR, and specifically that there is no link to autism, the rate of MMR vaccination in the population fell below that needed to afford herd immunity and cases of measles increased. Measles is a notifiable disease, and prompt notification of suspected cases to the Health Protection Agency allows steps to be taken to minimize further spread and protect those exposed.

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