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  #1  
Old 02-13-2014
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Default help me out!!!

A 6 year old boy is brought to the emergency department because of coughing,sneezing and rapid breathing for 6 hrs.he was diagnosed with an upper respiratory tract infection 2 days ago.his temp is 37 degree celcius pulse is 120,respirations are 44/min and blood pressure is 90/60 mm Hg. inspiratory and expiratory wheezes are heard throughout the lung fields.there is decreased tactile fremitus.which of the following is the most likely diagnosis?
A.ASTHMA
B.ATELECTASIS
C.BRONCHITIS
D.LEFT-SIDED HEART FAILUER
E.PNEUMOCOCCAL PNEUMONIA
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  #2  
Old 02-13-2014
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A. asthma ?
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  #3  
Old 02-13-2014
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Quote:
Originally Posted by hennizzzi View Post
A 6 year old boy is brought to the emergency department because of coughing,sneezing and rapid breathing for 6 hrs.he was diagnosed with an upper respiratory tract infection 2 days ago.his temp is 37 degree celcius pulse is 120,respirations are 44/min and blood pressure is 90/60 mm Hg. inspiratory and expiratory wheezes are heard throughout the lung fields.there is decreased tactile fremitus.which of the following is the most likely diagnosis?
A.ASTHMA
B.ATELECTASIS
C.BRONCHITIS
D.LEFT-SIDED HEART FAILUER
E.PNEUMOCOCCAL PNEUMONIA
Yes most likely the answer is (A. Asthma).
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  #4  
Old 02-14-2014
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Quote:
Originally Posted by whitecoat View Post
Yes most likely the answer is (A. Asthma).
Why not bronchitis?
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  #5  
Old 02-14-2014
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@nassesro : It can be bronchitis if stem has hints of cigarette smoking,sputum production etc
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Old 02-14-2014
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Quote:
Originally Posted by medicalbiology View Post
@nassesro : It can be bronchitis if stem has hints of cigarette smoking ,sputum productionetc
6 yr old boy
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Old 02-14-2014
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Originally Posted by nsesereso View Post
Why not bronchitis?

I think the key sign is "decreased tactile fremitus" which suggests airway obstruction.
the choices are confusing but I can't see a key sign in the stem that typically suggests any answer other than asthma.
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  #8  
Old 02-14-2014
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Why couldn't it be pneumonia?
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  #9  
Old 02-14-2014
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i was thinking Asthma but how does z decreased tactile fremitus go with asthma?????
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Old 02-14-2014
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I guess I thought the pneumonia was responsible for the fever, could an asthma attack last 6 hours?
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Old 02-14-2014
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Quote:
Originally Posted by hennizzzi View Post
i was thinking Asthma but how does z decreased tactile fremitus go with asthma?????
Yes, that is what I have found, tactile vocal fremitus is decreased when there is obstruction of vibration transmission; like in pleural effusion, fibrosis/pleural thickening, pneumothorax, bronchial obstruction or COPD.

So with the diffused expiratory and inspiratory wheezes throughout the lung, the answer will be most likely asthma (if asthma is severe there will be inspiratory wheezes).
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Old 02-14-2014
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Quote:
Originally Posted by dandaman486 View Post
I guess I thought the pneumonia was responsible for the fever, could an asthma attack last 6 hours?
There is no fever, the temperature is normal.
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  #13  
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i think ASTHMA should be z answer.
thanks every body
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