Daily assesment 18/08/17

1)  A mother presented with her 2 year old son who was left in care of her neighbour and was met watching television , he however has rash on the trunk, which was not there before leaving home.
Your registrar suspected physical Abuse and requested that you review before further plan.
Your examination shows widespread petechiae haemorrhage.

1. What four history will help you make diagnosis?
2. Mention Five of your differential diagnosis.
3. Mention three investigations that will help you make diagnosis.
4. The result of some of the investigations  are as shown below:
       WBC: 9000cells/ul.
       PCV: 34 Percent
       Platelet :52000cells/ul.
       Bleeding time : 17minutes.
       Prothrombin time: 12s.
       Activated plasma thromboplastin time: 40s.
a) what is the most likely diagnosis?
b)  Mention five causative agents.
C)  mention four treatment modalities.

2. Your Houseofficer has seen a 4year old boy with history of abdominal distention  of  a year duration,notable findings on  his examination include an abdominal mass extending from the right flank to the midline with smooth surface,   he could get above and below the mass, the child weighs 20kg and has a length of 78cm.

1) Mention four likely diagnosis.
2. Mention two investigations that are of outmost relevance in making diagnosis.
3. The chest radiograph reveal multiple well circumscribed opacities on the lung fields.
a).  What is your most likely diagnosis?
b). Mention four associations that may be expected.
c). What are the likely haematologic findings?
d).  Mention five clinical features expected?
e. Mention four prognostic factors in this patient.