USMLE Forum Archives - USMLE Step 2 CK - Pediatric abdominal pain
Pediatric abdominal pain
laparotomy - 01-06-08 13:35
A 10 year old girl presents with severe right lower quadrant pain. She vomited 3 times in the past 24 hours. She had a 1 week history of cough which is resolving, she also had constipation for the last 3 days. Her physical examination showed clear lungs, she has guarding and rebound in the right lower quadrant. Her labs showed a wcc of 19.7 and is otherwise normal. What is your diagnosis?
A. Acute appendicitis
B. Mesenteric adenitis
C. Ovarian torsion
D. Gastroenteritis
E. Perforated viscus
laparotomy - 01-06-08 13:35
A 10 year old girl presents with severe right lower quadrant pain. She vomited 3 times in the past 24 hours. She had a 1 week history of cough which is resolving, she also had constipation for the last 3 days. Her physical examination showed clear lungs, she has guarding and rebound in the right lower quadrant. Her labs showed a wcc of 19.7 and is otherwise normal. What is your diagnosis?
A. Acute appendicitis
B. Mesenteric adenitis
C. Ovarian torsion
D. Gastroenteritis
E. Perforated viscus
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#2
Re: Pediatric abdominal pain
laparotomy - 01-06-08 13:59 19.7 is not a normal white cell count it is very high...
#4
Re: Pediatric abdominal pain laparotomy - 01-06-08 14:25 What is your next step in management?
A. Open Appendectomy
B. Laparoscopy
C. Laparoscopic appendectomy
D. Ultrasound
E. CT
#5
Re: Pediatric abdominal pain 8401glacieres - 01-08-08 09:50 It's Ac Appendicitis
It needs to be operated by a laproscopic method.
#7
Re: Pediatric abdominal pain laparotomy - 01-31-08 11:22 I think it is safer to do an ultrasound examination first. Given the upper respiratory inferction history and the strong possibility of a mesenteric adenitis...
#8
Re: Pediatric abdominal pain radhamesramos - 01-31-08 11:52 of course, ultrasound must be done first, and then we'll see the diagnose... Is till think is an Ap. and the respiratory infection is a to trick us
#9
Re: Pediatric abdominal pain laparotomy - 01-31-08 13:17 Actually in this case it was a mesenteric adenitis, I think the take home message here is not to jump to our scalpels....
#12
Re: Pediatric abdominal pain funtonic - 02-01-08 15:23 Possible answers, appendicitis or acuter salpingitis, so A.
#13
Re: Pediatric abdominal pain laparotomy - 02-02-08 07:47 
posted by funtonic on 02-01-08 15:23
Possible answers, appendicitis or acuter salpingitis, so A.
Possible answers, appendicitis or acuter salpingitis, so A.
#14
Re: Pediatric abdominal pain taghrid - 02-02-08 08:33 You should give us more info about general condition, is there fever or hypotension, If there a confusion I think CT is the best if she is stable if not I think surgery is the option
#15
Re: Pediatric abdominal pain radhamesramos - 02-03-08 19:23 If it is a mesenteric adenitis> Hospitalisation, Antibiotics (ampicillin and genta is a good choice) fluid resuscitation and CBC every day.
#17
Re: Pediatric abdominal pain laparotomy - 02-07-08 08:39 We know appendicitis is the most likely but the big question is do you go in or not? To put it in the USMLE way, what is your next line of management?
#20
Re: Pediatric abdominal pain bingousmle - 06-30-10 16:53 the child has acute appendicitis.. the diagnosis is mainly clinical and the elevated wbc count further supports it .. so she should be operated for an appendectomy
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