Patient Screening

1. The mother of a 6-month-old infant calls the office requesting an appointment for her child. She advises that she thinks the child’s head appears swollen and that there are areas that appear to be bulging. What is your response regarding the appointment?
Based on the symptoms the mother has given, my diagnosis would be that the child could possibly suffer from the condition hydrocephalus. The symptoms which she described such as, swollen head, and bulging areas of the head share some of the same symptoms as hydrocephalus. Hydrocephalus is also more likely to occur during the infant stage, so the child is also within the likely age rage (6 months). I would advise the mother for prompt assessment (to be seen within 24hrs). In addition, schedule her for the next available appointment in the doctor’s office.
2. The mother of a 3-year-old boy calls to report her child had the onset of vomiting and abdominal pain during the night and is now experiencing blood in his urine. She says she just noticed a swelling on his left side toward his back. She requests and appointment. What is your response regarding the appointment? My diagnosis in this case would be that the child possibly suffers from Wilm’s tumor. The child is displaying symptoms such as mass in kidney region (swollen on the back left side), hematuria (urine in the blood), pain in the abdomen, and vomiting. Wilm’s Tumor occurs in children usually under 5 years of age, and this child is 3 years of age (within likely age range). I would advise the mother for prompt assessment, and schedule the next available doctor’s appointment.

3. The mother of a 15-day-old infant son reports that he started having episodes of vomiting with the emesis “shooting out of his mouth” after feeding. She also reports the infant appears hungry, continues to feed, and has not gained any weight. How do you respond to this call?
After listening to the mother describe her infants symptoms, it is possible that her son suffers from Congenital Pyloric Stenosis. The child has projectile vomiting which means he should be seen promptly. However, other symptoms the child exhibits include staying hungry and not gaining weight. Child is 15 days old and symptoms appear around 2-3 weeks of age. I would advise the mother for prompt assessment, and schedule the next available appointment in the doctor’s office.
4. Just as the office is closing for the day, a mother calls about her child who just started experiencing signs and symptoms of respiratory distress including hoarseness; fever; a harsh, high-pitched cough; and a funny, high-pitched sound during inspiration. The physician has already left the office for the day. How do you handle this call? From the symptoms the mother has described about her child it is possible her child could be suffering from croup. Symptoms include hoarseness, high-pitched cough, and fever. I’d advise the mother for immediate evaluation and to take her child to the ER.
5. A mother calls to report that her three children have been complaining of being fatigued, having headaches, and stomach, muscle, and joint pain for the last 2 weeks. She also states there has been a significant change in their behavior. How do you handle this call? My diagnosis in this case would be that her children possibly have tetanus. Her children are displaying signs of irritability and joint stiffness, along with many other symptoms that sound like tetanus. Signs such as, fatigue, head and stomachaches and muscle pain, could be spasms. I would advise mother for immediate evaluation, for the mother to take her children to the ER.

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