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A 4 month old female presents with several weeks of chronic wheeze and apneic episodes 20-30 minutes after feeds. She has been spitting up after feeds since birth. The infant has presented to the office on several occasions with the same complaint despite adjustments in feed technique and formula consistency. she is at the 5th percentile for weight. Whcih of the following is the moste appropriate pharmacological intervention?
A, Erythromycin
B, Fundoplication
C, Metoclopramide
D,Omeprazole
E,Ranitindine
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Answer C.
Metoclopramide is a prokinetic, so is Erythromycin but in this case there is no history of infection. Erythromycin is generally used in diabetic gastroparesis not only because diabetics are at high risk of infection but also because it is prokinetic. In the other hand, I believe that this case need a good investigation for the etiology of her condition because it seems to me that her condition is grave (5th percentile for weight!!!). Give Metoclopramide and investigate possible anatomic causes.
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Chronic Wheeze could indicate food particles aspirated rite....multiple apnea episodes also.. i think its better to give erythromycin...because it covers infection and also prokinetic rite...I dnt know whether this is a right answer....Just someone tell me the rite answer
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its E ...as the baby is suffering from GERD...in babies it could be only spitting curdled milk in that case you simply reassure mother that this will be resolved after a year and so but if GERD causing symptoms like chronic wheezing and apneic episodes plus FTT...so in this case she needs ranitidine not omeprazole cuz it reserved for even more worst symptoms of GERD...
hope it will help
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Do searching, you will see omeprazole is also used to treat GERD
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can gfr and creatinine vary day to day activity.
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E is correct. It is GERD and first step is to change feeding techniques and thickened feeds. If it didn't work give H2 antagonist. PPI and fundoplication reserved for severe cases. MTB 3 page 357
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@ surmountusmle
can u plz tell me the reason for chronic wheeze here......iam not getting an answer for that..
