COMSEP Clinical Cases
COMMON CHRONIC ILLNESS AND DISABILITY
- Smoke, dust and exercise trigger asthma attacks in an eleven-year-old boy with asthma. Both of his parents smoke and he would like 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?
- A fifteen-year-old boy with sickle cell disease is concerned because he has not yet developed facial hair and is considerably shorter than his peers. How would you counsel him?
- A fourteen-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?
- A seventeen-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?
- 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 medical conditions are these children at risk for?
- The parents of an eighteen-month-old boy are concerned because he is not yet walking. He has lower extremity hypertonia and hyperreflexia. What important historical information should you gather? How would you counsel the parents?
- During routine screening at fourteen-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?
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