Reference no: EM133274602
Assignment:
Patrick O'Donnell is a 22-month-old boy of Irish-American descent. His mother has concerns about loose stools for the past 3-to 4-months. His stools have gradually become looser and more frequent, and he has been "irritable" lately. His mother says he is active and sleeps well.She describes him as a "picky eater."
Patrick lives with both parents and a four-year-old sister, who is healthy.Because both parents work full-time, Patrick and his sister go to their grandmother's home Monday through Friday for daycare.His mom had not been particularly concerned about his crabbiness or picky eating until his Grandma mentioned that Patrick has been taking longer naps and she wonders how he'll ever get potty trained,because of his loose stools.
Objective
See Growth Chart
•Vital signs:weight (10.8 kg/23 lb.13 oz.), length (84 cm/33.25"), and temperature (97.6 ax).Seegrowth chart.
Some of Patrick's physical exam findings are as follows:
•General:Patrick is a thin, somewhat pale toddler, sitting quietly on his mother's lap.
•Cardiac:Cardiac exam is normal (no murmurs,cyanosis, or clubbing).
•GI:His GI exam reveals a slightly distended abdomen, active bowel sounds, sometympany,nontenderto palpation, withoutmasses orhepatosplenomegaly.
Skin:His skin is pale, with no rashes or lesions.You order some lab work:
CBC:All WNL for age exceptHgbis 10.0 g/dL: (ref: 11.0 to 14.0 g/dL)38
•tTG(TissueTransglutaminase):14.6 u/ml (ref:<4.0 is negative, 4 to 10 is weak positive, and >10.0 is positive)
1. Identify and discuss/analyze the most important aspects of Patrick's listed history ("red flags" in the subjective findings).What items are missing from Patrick's history?