Reference no: EM133618070
Problem
Patients with Muscular Dystrophy can experience cardiomyopathy. What would cause this and/or why would this occur?
How about isolated muscle hypertrophy, such as hypertrophy of the calf muscles that is typically seen in patients with Duchenne Muscular Dystrophy (DMD)? Why would patients with DMD manifest this finding?
A lab that is often ordered for patient's thought to have DMD or atl east in suspicion of having this disorder is a Creatinine Kinase (CK) level.
Why would this lab be ordered?
What CK result and lack of symptom would be indicative of a muscle disorder?
Is a CK level definitive for Muscular Dystrophy?
If DMD manifests in early childhood (3-4 years old typically), what gross motor milestones/activities would you expect the child to not be able to demonstrate?
Why would a patient with DMD need to use chest physical therapy, such as a manual cough assist, deep breathing, air/breath stacking, mechanical ventilation, and/or mechanical cough assist?
If deciding between which of these therapies would be most appropriate for your patient, what would be your determining factors aka, what would you need to know in order to make the most appropriate recommendation for your patient and family?
A patient is diagnosed with Reye syndrome and cerebral edema is noted on the results review within Epic from the cat scan (CT) performed last evening; isotonic maintenance fluids are currently infusing through a PICC line. During rounds would you consider asking for the rationale for the current fluids infusing and/or would you consider asking for a change in the IV fluids to a hypotonic or hypertonic solution? Why?
Reye syndrome: Why would we monitor cogs? What lab tests would indicate coagulation status? What would we administer if coagulation status was slightly compromised and how about severely compromised?
Kawasaki Disease: Why would salicylates and prednisone be indicated in this disease?
What type of CBC would you expect to have ordered for a patient with suspected Kawasaki dz.: CBC WITH or WITHOUT differntial?
Why would there be a shift to left in Kawasaki dz.? Which WBC would be particularly elevated in Kawasaki dz.?
Why would you expect for a C-Reactive Protein to be ordered for a patient suspected as having Kawasaki dz., but hasn't been diagnosed yet?
When differentiating between a child suspected as having either chicken pox (varicella) and Kawasaki dz. in the acute phase, these two diseases can be difficult to differentiate. Once a vesicular rash develops and it is known varicella is definitively suggested, what would be the rationale behind NOT ordering a CRP for this patient?
What would short term salicytate therapy look like for a patient weighing 15kg who has been diagnosed with Kawasaki Disease ? In other words what would the dose be PER DOSE, how often would they receive it and how long would the pt. receive the medication for?
Why would a patient with Kawasaki Disease be prescribed LONG TERM Salicylate therapy?
What would long term Salicylate therapy look like? In other words what would the dose most likely be in mg PER DAY, and how long would they need to be on it?
Patients with Kawasaki Disease are sometimes prescribed IVIG (Immune Globulin). Why would we ask a family to delay well-child immunizations until 11 months after receiving IVIG?
How does Prednisone help reduce the pathophysiology of nephrotic syndrome, thus decreasing symptoms? Why would a patient be prescribed immunosuppressant therapy in conjunction with Prednisone or instead of Prednisone?
How do you minimize side effects of steroids and immunosuppressive therapy?
What is hydronephrosis and why would it lead to metabolic acidosis, polyuria, & polydipsia?