Professional Documents
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PGI Pedia Pracs
PGI Pedia Pracs
) At the 1st minute of life, a newborn was noted to have a Cardiac Rate of 140, with active
movement, grimace to stimulation, acrocyanosis and good respiration
2.) An irritable 3 y/o Male with history of vomiting and loose stools was seen at the OPD
with pertinent physical examination of: sunken eyeballs, dry lips, hyperactive bowel
sounds and was noted to drink eagerly.
a
P.S. binago ko lng ung picture coz may part na di mabasa kanina pero same siya sa pic :)
3.) Baby Girl A is on her 58th hour of life. You noted that the jaundice was down to the
abdomen. Bilirubin Levels revealed Total Bilirubin 14.3 mg/dl,B1 12.2 mg/dl and B2 2.1
mg/dl.
Facts to consider: Physiologic jaundice: appears after 24 hours -> so this case is
Physiologic jaundice Peaks: Day 2-3, Disappears 5th day of life
Jaundice is level of abdomen: so estimate is 15 mg/dl -> DECREASED
BIOTRANSFORMATION (CONJUGATION)
a.Using the Bhutani chart at what zone will the bilirubin levels fall?
High-intermediate Risk zone ( because baby is on the 58th hour of life with a total serum
bilirubin of 12)
B. Using Kramer’s Chart what will be the approximated bilirubin levels of this patient?
jaundice was down to the abdomen -> 14 mg/dl ( I can’t find this sa Nelson’s )
C. What will be your plan of management?
-Firstly, phototherapy is indicated in High-intermediate risk zone.
-Explain that it resolves in 1 week in full term infants
-Interview patient to assess for need to do COOMB’s Test.
-Educate about breastfeeding and how it may ause jaundice
4.) Baby Zoe a 7 month old female came in the OPD for well baby check up.
Compute for the number of teeth/s expected for this age group?
7-months old: so 2 central incisors from mandibular area ( 5-7 months) + 2 central incisors
on maxillary area ( 6-8months) + 2 lateral incisors from mandibular area ( 7-10 months) = 6
teeth-> It is expected for her to have 6 teeth
Cinco trans:
Eruption usually occurs at 6 months mandibular central Incisors
o You can wait until 15 months of age
- Eruption of permanent teeth begins at around 6 y/o and completed around 18 y/o
- Visit to the dentist could be done as early as the first tooth erupts
Nelsons:
Initial mineralization begins as early as the 2nd trimester (mean age for
central incisors, 14 wk) and continues through 3 yr of age for the primary
(deciduous) teeth and 25 yr of age for the secondary (permanent) teeth.
6.) During a physical examination to an adolescent you noted that there is breast bud with
elevation of breast and papilla.
a.) Identify the SMR. Tanner Stage 2
b.) In getting the Personal and Social History of this patient using HEADSSS FIRST, what is
letter E? Education
c.) In interviewing the adolescent, what principle/s must you remember? Confidentiality? Lol
7.)
A. Identify Structure A? Anterior fontanelle
B. When do you expect Structure B to close?
2-3 months after birth
8.) A one year old boy with unrecalled vaccinations given developed fever. On his 3rd day
of illness, he was brought to the OPD. Upon oral examination, you saw: