Examkin

Soru

Zorluk: KolayPediatric Infectious Diseases

A 4-year-old boy is brought to the emergency department by his parents due to a widespread rash. He recently immigrated from a region with low immunization rates and has not received any childhood vaccinations. For the past four days, he has had a high fever, severe cough, runny nose, and red, watery eyes. Yesterday, a red, non-pruritic rash appeared on his face and has since spread down to his chest and back. His temperature is 39.4∘C39.4^\circ\text{C} (102.9∘F102.9^\circ\text{F}), pulse is 125/min125/\text{min}, and respirations are 24/min24/\text{min}. Physical examination reveals a generalized erythematous maculopapular exanthem. Examination of the oral cavity shows tiny white spots on a red base on the buccal mucosa opposite the premolars. The patient is placed in an airborne isolation room. Which of the following is the most appropriate pharmacotherapy for this patient's underlying condition?

  1. Administer oral vitamin ACevap
  2. B
    Administer intravenous ceftriaxone
  3. C
    Prescribe nebulized albuterol
  4. D
    Administer live-attenuated measles, mumps, and rubella (MMR) vaccine
  5. E
    Prescribe oral amoxicillin-clavulanate

Cevap

Administer oral vitamin A
This unvaccinated child presents with a textbook case of measles, characterized by a high fever, cough, coryza, conjunctivitis, pathognomonic Koplik spots on the buccal mucosa, and a spreading maculopapular rash. The measles virus depletes vitamin A stores, which can lead to severe complications such as blindness (xerophthalmia), pneumonia, and increased overall mortality. The World Health Organization recommends that all children diagnosed with measles receive two doses of high-dose vitamin A supplementation to replenish stores, promote epithelial cell regeneration, and boost the immune response, effectively reducing the severity of the disease.

Adım Adım Çözüm

1
Identify the clinical syndrome based on the patient's history and physical exam findings.
The patient has a classic presentation of measles (rubeola), indicated by the '3 Cs' (cough, coryza, conjunctivitis), Koplik spots (white spots on buccal mucosa), and a cephalocaudal maculopapular rash.
Accurate diagnosis is required to determine the appropriate disease-specific intervention.
2
Determine the standard recommended treatment for acute pediatric measles.
The World Health Organization (WHO) and standard pediatric guidelines recommend high-dose vitamin A supplementation for all children with acute measles.
Vitamin A deficiency is heavily associated with severe measles complications (e.g., pneumonia, blindness, encephalitis); supplementation significantly reduces morbidity and mortality.

Anahtar Kavram

The administration of high-dose vitamin A is the primary pharmacotherapeutic intervention to reduce morbidity and mortality in children with acute measles.
Tahmini Süre:50s
Bu soruyu puanla

Konular

Pediatric Infectious Diseases

Bu konudan daha fazla soru