Winded : Part 1

Respiratory System

Step 1: View Clinicals

{"ops":[{"insert":"A 6 year old boy presents with wheezing and a nonproductive cough for 2 hours.\n\nHe is a refugee, and thus detailed medical records are unavailable. However, his mother mentions that he has experienced recurrent episodes of wheezing from the age of 7 months onwards; for the last 2 years, these have occasionally been accompanied by cyanosis and epistaxis.\n\nHe has also been persistently anemic from the age of 3 years, which was attributed to a poor diet.\n\nHis surgical and family histories are unremarkable, while his development is age-appropriate, and all immunizations are up to date.\n\nAt the emergency department, he was started on oxygen via face mask and back-to-back nebulization with salbutamol and ipratropium bromide. However, his vital parameters have continued to deteriorate.\n\nAn urgent chest X-ray reveals reticular and nodular opacification of the perihilar and basal regions with sparing of the apices and costophrenic angles. An ECG is normal.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-069_en.png"}},{"insert":"\n"}]}

Step 2: Order Relevant Investigations

1. Complete Blood Count
2. Portable Echocardiography
3. Arterial Blood Gases
4. CT Pulmonary Angiography

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