A).

Gregory is a 5 year old boy who has been brought to Accident and Emergency Department after a friend’s parent dialed 999.While at their sons birthday party he complained of tummy ache, started vomiting and then had profuse watery diarrhoea. He also became acutely wheeze and was struggling to breathe. His voice became horse and he was obviously scared. the ambulance reported that when they arrived he was barely conscious, had sever stridor and markedly increased workbook breathing . He is known to have asthma and eczema, both reasonably well controlled. his parents report that he had cows milk intolerance as a toddler, with vomiting and poor weight gain, and develops urticaria if he eats eggs.

The ambulance crew gave him a life saving drug treatment. What was it?

How would you continue his immediate management

once he

B).

A 25 year old woman was brought to emergency department complaining of right iliac fossa pain. The pain had developed rapidly over approximately 40 minutes and was associated with cramps and vomiting. The surgical intern made an initial diagnosis of apendicitis

If the surgical intern consulted you a senior surgeon. What would you advise him to do to obtain the true diagnosis

Answer

How Anatomy works

1) The 5 year old boy was administered epinephrine injection. Immediate management would be Assess Airway, Assess Breathing, and Asses Circulation.  If still in respiratory distress the emergency room physician should consider providing nebulized adrenaline. Anesthesiologist must be available if symptoms worsen. Otherwise, when the boy is settled. Investigate the last food intake and perform skin test to determine what the boy is allergic to.

2.  I would advise the surgical intern to obtain a  focussed appendix computed tomography (FACT)