BMB 420 Lecture 5: Case study: Nipple Naysayer

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Bernard
Case Study: Nipple Naysayer
6 month old male
-Brought to the ER by mother
-Suffering from visible floppiness
-Poor head control
-Patient suffering from audible respiratory difficulty
-Weakly crying with no production of tears. Eyes appear sunken.
Constipated onset 4 weeks previous, 2 stools in the last 3 days.
Three days prior to admission, decreased breast feeding. Took 1 hour for what should have been
15 min.
Displayed general weakness, decreased movement, difficulty sitting and not breastfeeding.
Morning of, had increase floppiness.
Patient was born to term, no complications noted. No history of surgery or illness, no
medication, no known allergies, diet is of milk, sweet potatoes, and rice cereal. Generally sleeps
through the night and naps 2-3 times per day, though parents have noticed increased lethargy
during the day. Has not received any vaccinations.
No siblings, mother has IBS and both parents have asthma. Maternal grandparents struggle with
hypertension, paternal grandparents both died of cancer (G.M: breast, G.F: colon), no exposure
to smoking.
Height: 28in (average 28)
Weight: 15.2 lbs (average 14-21)
Blood pressure: 85/60mm Hg (okay range)
Respiration rate: 27 breaths per min (low)
Pulse: 110 beats/minute
Temp: 100.5 F
Diagnotics:
Chest Xray showed nothing out of ordinary, blood and urine show dehydration.
Spinal tap to test for CNS
Normal/CNS Infection
Pressure: 10-18 cm water (increases in case of infection)/ 25cm
Colorless/yellow, orange, pink, clear
Clarity: clear/turbid
Viscosity: watery/thick or watery
Protein: <45 mg/dL/50mg
Glucose: 50-80 mg/dL/30-80 mg
WBCs: 0-5 cells/0-1000
ANC: <1 cell/mm/ >1 cell (one neutrophil present)
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Document Summary

Constipated onset 4 weeks previous, 2 stools in the last 3 days. Three days prior to admission, decreased breast feeding. Took 1 hour for what should have been. Displayed general weakness, decreased movement, difficulty sitting and not breastfeeding. Patient was born to term, no complications noted. No history of surgery or illness, no medication, no known allergies, diet is of milk, sweet potatoes, and rice cereal. Generally sleeps through the night and naps 2-3 times per day, though parents have noticed increased lethargy during the day. No siblings, mother has ibs and both parents have asthma. Maternal grandparents struggle with hypertension, paternal grandparents both died of cancer (g. m: breast, g. f: colon), no exposure to smoking. Chest xray showed nothing out of ordinary, blood and urine show dehydration. Pressure: 10-18 cm water (increases in case of infection)/ 25cm. Anc: <1 cell/mm/ >1 cell (one neutrophil present) All signs are indicative of lack of infection.

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