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6 2552

.

6 2552


6 2552

  • Pitfall management

    1.

    2.

    3.


Common cold

( Common cold )

  • rhinovirus, RSV, influenza virus


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  • 4-6 10-15

  • (cool gel)


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  • 6

    0.9%NSS 1-2 0.25-0.5% ephedrine 5


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  • guaifenesin glyceryl guaiacolate dextrometrophan

  • Vitamin C


Acute pharyngitis tonsillitis

(Acute pharyngitis,Tonsillitis)

  • group A beta hemolytic streptococcus (GABHS )

  • 5


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GABHS > 2

  • Throat swab culture


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  • GABHS penicillin50,000-100,000 /./ 3 10 Amoxycillin 30-50 ././ 10 penicillinerythromycin 30-40 ././ 10

    10 acute rheumatic fever acute glomerulonephritis


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  • Pitfall management

    1.

    2.

    3.


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3 1 1

)

  • rotavirus shigella salmonella , E.coli


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  • 2

    1. Dysentery diarrhea

    2. Non-dysentery diarrhea


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  • V/S , 2

    1. rehydration

    5-10% deficit in 4-6 5%DNSS 5%DN/2

    2. 24

    Maintenance +concurrent loss


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  • ORS Reduce osmolarity 75 mmol/L ORS

  • shigella shigella


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norfloxacin 10-20 ././ cetriaxone 50 ././


Wheezing child

Wheezing Child

  • Pitfall management

    1. wheezing

    2. wheezing


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  • Wheezing asthma, allergy, croup, foreign body


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  • Acute wheezing < 3 respiratory tract infection acute bronchiolitis , croup, viral pneumonia first attack asthma > 3 asthmatic attack

  • Recurrent wheezing wheezing 2 asthma


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  • asthma

    - unilateral asymmetrical wheezing,

    - failure to thrive,

    - stridor,

    - clubbing finger


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asthma

  • recurrent wheezing ,

  • ,

  • expiratory wheezing


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wheezing asthma

Specific treatment

  • Beta2 agonist salbutamol terbutaline inhale, oral ventoline solution 0.01-0.03 cc/kg/dose NSS 3-3.5 cc

  • Steroid acute asthmatic attack prednisolone 1-2 mg/kg/day Hydrocortisone IV 3-5 mg/kg/dose 4-6


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Supportive and symptomatic treatment

  • Oxygen

  • IV fluid = maintenance+dehydration SIADH

  • Antibiotic

  • Antihistamine drying effect


Recurrent abdominal pain

Recurrent Abdominal Pain

  • Pitfall management

    1. Dyspepsia

    2.


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  • 3 3

  • functional abdominal pain


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Organic abdominal pain

  • organomegaly


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  • 1.Reassurance

    2.Psychological support


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3. Environment modification

4. fiber caffeine

5. dyspepsia ranitidine, domperidone, omeprazole, antacid


Pneumonia

( Pneumonia )

Pitfall management

1.

2. thrombophleblitis ,pleural effusion

3. ..2552 Influenza virus H1N1 add Oseltamivir


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  • Adenovirus, Influenza virus Streptococcus pneumoniae, Mycoplasma pneumoniae host


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  • retraction crepitation rhonchi

  • CBC, film CXR, sputum G/S C/S, nasopharyngeal swab


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*

Bacterial pneumonia Viral pneumonia

Onset Abrupt Gradual

  • Temperature > 38.5 c < 38.5 c

  • Lung crepitation wheezing ,rhonchi

  • WBC > 15,000 < 15,000

  • PMN > 10,000 < 10,000

  • CXR alveolar , patcy infiltration Hyperinflation,

  • Pneumatocele, pleural effusion Interstitial infiltration


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  • Oseltamivir case Influenza

  • CXR

  • < 20 Admit group B streptococci gram negative bacilli

    Ampicillin (100-200 MKD) + Gentamicin (5-7 MKD) 3rdCephalosporin Claforan (100-200 MKD) 7-10


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  • 3 -3

    C.tracomatis

    Erythromycin 10-14

    Admit Ampicillin 3rdCephalosporin


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  • 3 -5 S.pneumoniae H.influenzae

    Amoxycillin 40-50MKD Penicillin Erythromycin

    2 Augmentin (40-50 MKD amoxy)

    admit 3rdCephalosporin Augmentin 10-14


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  • 5-15

    M.pneumoniae Erythromycin 7-10 S.pnemoniae Amoxycillin Penicillin 7-10

    Ampicillin 3rdCephalosporin 10-14

    S.aureus ( CXR pneumatocele) Cloxacillin (100-150 MKD) 3


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  • 1. Oxygen sat room

    air < 92%

  • 2. electrolyte

    SIADH

  • 3. wheezing

    rhonchi


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  • 2 pleural effusion, pneumatocele, lung abscess film x-ray

  • septicemia osteomyelitis, septic arthritis S.aureus


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THANK YOU

FOR

YOUR ATTENTION


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