~~Clinical Exam Case~~

Just finished my Clinical examination: Paediatric case

Long Case : 4 yers old malay boy with

1) Cerebral palsy with Left sided dyskinesia due to kernicterus?

2) Right Hemiplegia due to subdural hemorrhage (at 10months age)

3) Global developmental Delay

4) Epilepsy (at 1 year)

-has multiple hospital admission due to recurrent chest infection, AGE & seizure

-Achillis tendon release R limb due to contracture

O/E

-Scar for Left subdural hemorrhage (bentuk ladam kuda)

-Patient has Rt UMN lesion of UL & LL

-Choreoathetoid movement of Lt UL & LL

-Drolling saliva at Rt side

-Gait hemiplegic? (xtaula..pelik sgt gait die)

-Developmental-about (9month-1 year) of age

-He is making incomprehensive sound (tak bleh cakap lagi)

Discussion:

What do you think the age of the patient now?

Why he had hemiplegia?

What is your diagnosis?

How u investigate?

How you want 2 differentiate between non-accidental injury? (seyes xbaca lgsung bab ni) - i ans look for other injury such as abdominal injury,MSK & other scar

What specifically in eyes finding for (NAI)?

how about brain finding in (NAI)?

Since he cannot talk, how he communicate with his mother?

How do you manage this patient?

What is the affect of this disease to the family member?

Is it affect his dad carrier?

he still cannot talk,is he underwent speech therapy? how many time?

Any special shoes finding in patient with hemiplegic gait?

wakaka...semua soalan basically about psycosocial issue...

So, kenela ask about psycosocial....

Terus rasa cam blur jer pas habis exam....uhukuhuk

Choreoathetoid CP + Rt sided Hemiplegic due to Subdural hemorrhage

Short cases

1) Medicine- Mitral regurgitation, loud P2 (Chronic Rh heart diease)

2) O&G - Multiple pregnancy

3) Surgery - Bilateral Direct Hernia