COMMON CHRONIC ILLNESS AND DISABILITY

1. Smoke, dust, and exercise trigger asthma attacks in an 11 year-old-boy with asthma. Both or his parents smoke and he is desperate to play basketball on the school team. Discuss the medical management of this child. How would you negotiate an asthma care plan with the child and family?
2. A 15 year old boy with sickle cell disease is concerned because has not yet developed facial hair and is considerable shorter than his peers. How would you Council him?
3. A 14-year-old girl with previously well-controlled insulin dependent diabetes mellitus presents in diabetic ketoacidosis for the third time in the past six months. What are the issues that might be adversely affecting her diabetes control?
4. A 17-month old girl is diagnosed with cystic fibrosis after her third hospitalization for pneumonia. Her mother is pregnant. What are the short and long term implications for this girl? What are the implications for the family including the unborn child?
5. A newborn has hypotonia, downward slanting palpebral fissures, a single palmar crease, and an III/VI holosystolic murmur at the mid left sternal border. What would you tell the parents? What are the short-term implications? What are the long-term implications?
6. The parents of an 18-month-old boy are concerned because he is not yet walking. He has lower extremity hypertonia and hyperreflexia. How would you Council the parents?
7. During routine screening at 14 weeks gestation, the mother of one of your patients is found to be HIV antibody positive. What interventions can be done to minimize perinatal transmission? After delivery, how would you confirm or exclude HIV infection in the infant?