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  #1  
Old 07-18-2010
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Kids Febrile child not responding to acetaminophen ...

A 5-year-old child presents with fevers of 103F for over a week. The fevers have not responded to acetaminophen. On exam, the child has swollen hands and feet, conjunctivitis, and a strawberry tongue. Prior to this illness, he has had no significant medical history and has been developmentally normal. Despite immediately starting treatment with IVIG, aspirin and corticosteroids, you warn the parents that the child may develop which of the following?
A. Supraventricular arrthymias
B. Coronary artery aneurysm
C. Pericarditis
D. Amylodiosis infiltration of myocyte
E. Atherosclerotic coronary artery disease
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Old 07-18-2010
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B child has kawasaki ---coronary artery aneurysm
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Old 07-18-2010
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Default yes i agree

i think the answer is B too. the symptoms (swollen extremities), conjunctivitis n fever points towards kawasaki. so the complication is coronary artery aneurysm.
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Old 07-18-2010
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B. kawasaki
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Old 07-19-2010
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yep The correct answer is B.

Children with Kawasaki disease should be hospitalized and treated with IVIG, aspirin and sometimes, corticosteroids. Despite early treatment, the incidence of coronary artery aneurysm formation later in life is elevated. The etiology of Kawasaki disease is unknown, but it is a mucocutaneous lymph node syndrome that also affects small and medium sized vessels. Several symptomatic criteria are required to diagnosis this condition, including a high grade fever over 5 days, conjunctivitis, red mucous membranes of the mouth, a strawberry tongue, red palms, swollen hands and feet, enlarged lymph nodes, and a rash.
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Old 07-19-2010
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Quote:
Originally Posted by doctorF View Post
yep The correct answer is B.

Children with Kawasaki disease should be hospitalized and treated with IVIG, aspirin and sometimes, corticosteroids. Despite early treatment, the incidence of coronary artery aneurysm formation later in life is elevated. The etiology of Kawasaki disease is unknown, but it is a mucocutaneous lymph node syndrome that also affects small and medium sized vessels. Several symptomatic criteria are required to diagnosis this condition, including a high grade fever over 5 days, conjunctivitis, red mucous membranes of the mouth, a strawberry tongue, red palms, swollen hands and feet, enlarged lymph nodes, and a rash.
thanks this was an awesome question to remind us of our pathology. ive seen kawasaki questions quite a few times. i think it's safe to expect it in the exam.
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Yep i found it very nice question thats y posted it here
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