<body><script type="text/javascript"> function setAttributeOnload(object, attribute, val) { if(window.addEventListener) { window.addEventListener('load', function(){ object[attribute] = val; }, false); } else { window.attachEvent('onload', function(){ object[attribute] = val; }); } } </script> <div id="navbar-iframe-container"></div> <script type="text/javascript" src="https://apis.google.com/js/platform.js"></script> <script type="text/javascript"> gapi.load("gapi.iframes:gapi.iframes.style.bubble", function() { if (gapi.iframes && gapi.iframes.getContext) { gapi.iframes.getContext().openChild({ url: 'https://www.blogger.com/navbar.g?targetBlogID\x3d15298599\x26blogName\x3dThe+Daily+Rhino\x26publishMode\x3dPUBLISH_MODE_BLOGSPOT\x26navbarType\x3dBLACK\x26layoutType\x3dCLASSIC\x26searchRoot\x3dhttps://dailyrhino.blogspot.com/search\x26blogLocale\x3den_US\x26v\x3d2\x26homepageUrl\x3dhttps://dailyrhino.blogspot.com/\x26vt\x3d466226327317036497', where: document.getElementById("navbar-iframe-container"), id: "navbar-iframe" }); } }); </script>
The Daily Rhino
Friday, December 30, 2005

Medical Student Teaching #3
Presenting Complaint - Paediatric Fever

THIS teaching session concerns a three year old Japanese boy whom you see in A&E. His mother informs you that he has had a fever for seven days, which began soon after a ride on his father’s motorcycle. He has been crying excessively, more so over the last 48 hours. He has vomited and had an episode of diarrhoea. The toddler has been rather drowsy and occasionally makes a low-pitched humming noise and holds his hands out in front of him. His mother also reports that her son frequently places bowls on his head when he does this.

On examination the young boy is crying and has a fever of 38.9C. His heart rate is 120. You notice cracked and red lips, a blotchy rash and peeling hands. On auscultation you notice that the child is Vrrroooooom test positive. You order some investigations:

ECG – prolonged PR interval
ESR – 88mm/hr
Echo – ?Mild ectasia.

You are not entirely sure until a passing mime artist gestures that you should check the blood film, shown below.

What's the diagnosis?

That's right, it's Kawasaki’s Disease. The presence of minute Japanese motorbikes in the blood is pathognomonic for Kawasaki’s. One must remember to use the maximum possible magnification, as very small motorbikes can often be mistaken for endoplasmic reticula. One must be mindful to distinguish between the harmless Suzuki vasculitis and the rapidly fatal Yamaha fever – make a Kwik-Fit referral.

Kawasaki’s is often associated with Ruff Ryder’s Syndrome - treatment involves gradually starving the child of petrol, replacing this with diesel and playing DMX music on loop. Prescribe steroids, they never do any harm. Honestly, they're fucking awesome.

Medical Student Teaching #1
Medical Student Teaching #2

Originally published in Medical Student Newspaper.

Technorati tags:

Labels: ,


Permanent link action

Post a Comment

Diversity Writer of the Year
Image Hosted by ImageShack.us
Runner-up Columnist of the Year
Nominated Features Writer of the Year


Sepia Mutiny
It's the Pirates
Yam Boy
Video Wallah
Shiva Soundsystem
Within / Without

Saheli Datta
Random Acts of Reality
NHS Blog Doc
The Oracle

Cabein (Kunal Anand)
Ethno Techno

1. Much Apu about nothing
2. Rohinplasty (series)
3. Medical student teaching (series)
4. What your stetho says about you
5. Revision: IT BRINGS DEATH
6. Things you kids won't see (series)
7. Tsunami Politics
8. Churchill: Let the fakir die
9. If it looks like a quack...
10. Ten million missing girls

Looks and talent - unrelated

Misplaced heritage and a new boast for India

Make it so

The Ghost of the Tower

Tsunami Politics

Remembering the wave

The Middle East's finest female singers

Great Scott!


Hot blogs and hotter girls

Subscribe with Bloglines

Top of the British Blogs

Rotate Your Mind

August 2005
September 2005
October 2005
November 2005
December 2005
January 2006
February 2006
March 2006
April 2006
May 2006
June 2006
November 2006
December 2006
February 2007
May 2007
June 2007
July 2007
August 2007
October 2007
November 2007
February 2008
March 2008
April 2008
May 2008
July 2008
December 2008

Web This site