Lessons from the Grand Rounds 2: Options in Rational Management

Section 1 TIME TESTED HYPOTHESIS
Case 1 Patient hearing a must !!
Case 2 History begins with age. How old are you?
Case 3 History begins with age
Case 4 Respect chief complaints
Case 5 Respect chief complaints
Case 6 Origin matters
Case 7 Origin matters
Case 8 Do not ignore clinical setting
Case 9 Do not ignore clinical setting
Case 10 Duration is important
Case 11 Caution against unexpected progress
Case 12 Sudden improvement may be ominous
Case 13 Beware of partial improvement
Case 14 Monitor progress of fever:: Biphasic fever
Case 15 Past-A lead for the future
Case 16 Attention to personal history
Case 17 First impression
Case 18 General examination is special
Case 19 Correlate temperature, pulse and respiration (TPR)
Case 20 Observe pattern of breathing
Case 21 Listen to the sounds that breathing makes
Case 22 Nail down the diagnosis
Case 23 Stick out the neck
Case 24 Stretch your imagination
Case 25 Head start
Section 2 MANAGEMENT DILEMMAS IN OFFICE PRACTICE
Case 26 Viral fever
Case 27 Enteric fever
Case 28 Enteric fever
Case 29 Enteric fever
Case 30 Frequent illnesses diagnosed as primary complex twice
Case 31 Short stature due to IUGR with malpositioned kidney
Case 32 Breastfed baby with intermittent blood in stools
Case 33 Breastfed baby with suspected GI infection who recovered fast
Case 34 Empyema
Case 35 Empyema who was given steroids
Case 36 Rheumatic fever
Case 37 UTI-1st episode at 4 years of age
Case 38 Constipation
Case 39 Nephrotic syndrome
Case 40 Immune thrombocytopenic purpura
Case 41 Reactive arthritis secondary to mediastinal malignancy
Case 42 Mismanaged gastroenteritis
Case 43 Inadequate feeding investigated for failure to thrive
Case 44 Infant with atypical Kawasaki disease
Case 45 Fungal pneumonia
Case 46 Palatopharyngeal incompetence
Case 47 Hemophagocytic syndrome
Case 48 Leukemia presenting as scurvy
Case 49 Poststreptococcal reactive arthritis
Case 50 Suspected Kawasaki disease presenting in 2nd week
Case 51 Galactosemia
Case 52 Mismanaged UTI presenting as breathlessness
Case 53 Gaucher disease
Case 54 Autoimmune disorder
Case 55 Idiopathic thrombocytopenic purpura
Case 56 Sudden falls in a 12-year-old
Case 57 Dengue shock syndrome
Case 58 Capillaria hepatica Fever with skin rash
Case 59 Systemic inflammatory disorder
Case 60 Meningococcemia
Case 61 Stevens-Johnson syndrome
Case 62 Dengue shock syndrome
Case 63 Rickettsial disease
Case 64 Severe combined immunodeficiency
Case 65 Streptococcal infection
Case 66 Hodgkins lymphoma Inborn errors of metabolism
Case 67 Metabolic disorder presenting as complication of diarrhea
Case 68 Metabolic disorder presenting as unexplained encephalopathy
Case 69 Urea cycle defect
Case 70 Galactosemia
Case 71 Phenyl ketonuria
Case 72 Mitochondrial encephalopathy with lactic acidosis
Case 73 Metabolic disorder with cardiomyopathy
Case 74 Ataxia presenting as metabolic disorder
Section 3 AN APPROACH TO RECURRENT/ PERSISTENT PNEUMONIA
Case 75 Clinical recovery, radiological persistence duplication of esophagus
Case 76 Clinical recovery, radiological persistence
Case 77 Clinical recovery, radiological persistence
Case 78 Clinical and radiological persistence
Case 79 Clinical persistence, radiological recovery
Case 80 Recurrent pneumonia at the same site
Case 81 Subacute pneumonia
Case 82 Nonbacterial etiology
Case 83 Complication
Case 84 Complication
Case 85 True recurrence
Case 86 True recurrence
Recurrent cough with or without wheezing
Case 87 Wheeze associated lower respiratory infection
Case 88 Gastroesophageal reflux disease (GERD)
Case 89 Achalasia cardia
Case 90 Coarctation of aorta
Case 91 Cystic fibrosis
Case 92 Foreign body
Case 93 Miliary tuberculosis
Recurrent cough, cold and fever in office practice
Case 94 Frequent viral infections
Case 95 Asthma
Case 96 Bacterial infection secondary to adenoid hypertrophy
Comparison/comment on the above three cases
Case 97 Recurrent cold and fever
Recurrent abdominal pain
Case 98 Habitual constipation
Case 99 Meckels diverticulum
Case 100 Dyspepsia
Case 101 Functional abdominal pain
Case 102 Inflammatory bowel disease
Case 103 Irritable bowel syndrome
Recurrent diarrhea
Case 104 Recurrent GI infection
Case 105 HIV infection
Case 106 Gluten induced enteropathy
Case 107 Chronic giardiasis
Case 108 Recurrent swelling around angle of mandible
Section 4 VAGARIES IN TUBERCULOSIS
Host chooses pathology and decides the outcome
Case 109 Lobar emphysema as a presentation of large mediastinal lymph node
Case 110 Missed mediastinal lymph node enlargement on routine chest X-ray
Case 111 Missed mediastinal lymph node enlargement on routine chest X-ray
Case 112 Acute onset pleural effusion that was TB
Case 113 Localized pleural effusion
Case 114 Tuberculous empyema
Case 115 Bilateral pleural effusion
Case 116 Subacute pneumonia missed as acute bacterial pneumonia
Case 117 Mediastinal lymph node, cavity and miliary lesion in same child at a time
Case 118 Fever, cough, breathlessness (TB lymph node and miliary)
Case 119 Recurrent arthritis as an immune mediated manifestation of TB
Case 120 Persistence of fever for months in spite of radiological improvement
Case 121 Suspected MDR TB
Case 122 MDR TB
Case 123 Extensive tuberculosis in infant poorly responsive to treatment
Case 124 Worsening mediastinal lymph node enlargement on recovery of primary complex
Case 125 Development of cervical lymph node on recovery of TB pneumonia
Case 126 Recurrence of meningitis on compliant anti-TB therapy
Case 127 Development of tuberculoma on recovery of TBM
Case 128 BCG lymphadenitis
Case 129 Flaring of BCG scar as a manifestation of immune disorder
Case 130 Psoriatic arthritis mistaken for TB
Case 131 Suspected abdominal TB
Case 132 Multiple recovering bony lesions of Hodgkins mistaken as TB
Case 133 TB lymphadenitis which was lymphoma
Index