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23 Nov 2019

The majority of pediatricians enter what field upon completion of residency?

Surgery

National Policy Making

General

Internal Medicine

Family Practice

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Deanna Hettinger
Deanna HettingerLv2
5 Nov 2019
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Related questions

first noticed in newborns when the urine in their diapers turnsblack upon exposure to air. The condition is caused by thedefective transport of the amino acid phenylalanine through theintestinal walls during digestion. About 4 people per 1000 arecarriers of alkaptonuria.


Sara and James had never heard of alkaptonuria and were shocked todiscover that their first child had the condition. Sara's sisterMary and her husband Frank are planning to have a family and areconcerned about the possibility of alkaptonuria in one of theirchildren.
The four adults (Sara, James, Mary, and Frank) seek informationfrom a neighbor who is a retired physician.

After discussing their family histories, the neighbor says, "I never took genetics, but I knowfrom my many years in practice that Sara and James are bothcarriers of this recessive condition. Since their first child hadthe condition, there is a very low chance that the next child willalso have it, because the odds of having two children with arecessive condition are very low. Mary and Frank have no chance ofhaving a child with alkaptonuria because Frank has no familyhistory of the condition."

The two couples each have babies and both babies havealkaptonuria.

Part A

The neighbor was apparently incorrect in her assessment thatthere would be "no chance" of Mary and Frank having a child withalkaptonuria. Assume that before the birth of Mary andFrank's baby, you had been asked...

What would the probability be of Mary and Frank having a childwith alkaptonuria?

Enter your answer as a reduced fraction. For example: 1/2, not8/16 or 0.50

Part B

What is the chance that the third child of Sara and James willbe free of the condition?

Enter your answer as a reduced fraction. For example: 1/2, not8/16 or 0.50

Part C

Sara and James are now worried that one of theirgrandchildren will inherit alkaptonuria. What is thechance that the first child of their daughter with alkaptonuriawill be affected by alkaptonuria? Assume that their son-in-law hasno family history of alkaptonuria.

Enter your answer as a reduced fraction. For example: 1/2, not8/16 or 0.50.

Mrs. Fox, a 40-year-old wife and mother of 2, was involved in a massive motor vehicle accident on the Sawmill Parkway in which her car struck the center divider and flipped twice. A good Samaritan immediately dialed 911. First responders found the patient unconscious with severe injuries but were able to safely transport her to St. John’s Riverside Hospital. Upon arrival at the emergency department, Mrs. Fox was immediately triaged and the following impairments were found: blunt force trauma to the head, open fracture to the right leg, possible closed fracture to the right wrist/forearm, and internal bleeding to the upper right abdominal quadrant (possibly from the liver). Hospital staff was able to contact the patient’s next of kin (family) to inform them of her condition.

Mrs. Fox was stabilized, imaging and tests were ordered/performed, and medically necessary surgical intervention was carried out. The patient was transferred to the ICU of the hospital as she continued to fluctuate in and out of consciousness and had difficulty breathing without the use of a respirator.

Within a week, the patient fully regained consciousness, was able to breathe on her own, and was determined to be safe enough to be transferred to the general inpatient floor of the hospital. It was determined that Mrs. Fox had sustained a traumatic brain injury predominately affecting sensation and motor function to the right side of her body. She was placed on a restrictive diet and prescribed medication to treat her healing liver as well as diuretics to decrease the fluid compressing her brain. A pin was placed in the patient’s right wrist to fixate the fractured scaphoid bone. The right tibia was fixated with an intramedullary (inside the bone) rod and pins. Neurovascular structures were repaired to the best of the surgeon’s ability; however, the prognosis of her right leg was undetermined based on the severity of damage.

Based on the case scenario above, answer the following questions:

1. Of the health professionals discussed thus far, which may be involved in Mrs. Fox’s care?

2. What would be the role of each provider?

3. Why might providers need to communicate with one and other specific to this case?

4. How might they communicate?

5. What other healthcare team members, not yet discussed, might be involved and what would be their roles?

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