04-01-2006, 04:48 AM
NORWALK HAS OPENED THE FILE AGAIN
PROBABLY HE WANTS TO SAY THAT IT IS POLY MYOSITIS, THE HIP JOINT / HELIOTROPE RASH / CANOT WALK --SO MAY BE HE POLYMUOSITIS MAY COME TO MIND BUT POLYMUOSITIS OCCUR IN EARLY 30 S. AND EYES ARE SWOLLEN NOT HELIOTROPE/ AND HOW CAN YOU EXPLAIN THE BRUISE OVER THE CHEST/?
hepatitis can cause bruises like thing but he should have hepatic encephalopathy too. though he has lethargy which can be present in hepatic encephalopathy . he does not have hyper reflexia as the vignette say that deep tendon reflex are symmetric.
toxic hepatiis acetaminophen poisoining are also dumped down for the same reason. so all other cause except chid abuse are excluded easily.
and finally child abuse is only remaining and there are strong points in support of it. so norwalk is right also child abuse is never a first diagnosis. this is the last but not the least diagnosis.
meaning child abuse is the only answer over here
PROBABLY HE WANTS TO SAY THAT IT IS POLY MYOSITIS, THE HIP JOINT / HELIOTROPE RASH / CANOT WALK --SO MAY BE HE POLYMUOSITIS MAY COME TO MIND BUT POLYMUOSITIS OCCUR IN EARLY 30 S. AND EYES ARE SWOLLEN NOT HELIOTROPE/ AND HOW CAN YOU EXPLAIN THE BRUISE OVER THE CHEST/?
hepatitis can cause bruises like thing but he should have hepatic encephalopathy too. though he has lethargy which can be present in hepatic encephalopathy . he does not have hyper reflexia as the vignette say that deep tendon reflex are symmetric.
toxic hepatiis acetaminophen poisoining are also dumped down for the same reason. so all other cause except chid abuse are excluded easily.
and finally child abuse is only remaining and there are strong points in support of it. so norwalk is right also child abuse is never a first diagnosis. this is the last but not the least diagnosis.
meaning child abuse is the only answer over here