nb 1 - april17

[ArchivalUser]

5 month old boy is brought for a follow-up examination. He was born at 37 weeks' gestation and has had persistent wheezing since shortly after birth despite treatment with nebulized and oral bronchodilators and oral corticosteroids. His diet consists of 32 ounces of iron-fortified cow's milk-based formula daily. He appears well nourished and happy. On examination, there is moderate relief of wheezing with extension of the neck. Which of the following is the most likely mechanism of this infant's wheezing?
A) Allergic reaction to cow's milk
B) Aspiration of a foreign body
C) Compression of the airway by a vascular ring
D) Concurrent upper respiratory tract infection
E) Persistent immaturity of lungs

[ArchivalUser]

C..Compression of the airway by a vascular ring ?
but what is vascular ring would you please explain..

[ArchivalUser]

i would go with c.
since it present with the birth

[ArchivalUser]

C. compression of the air way by a vascular ring. This appears to be the only congenital abnormality in the options that made sense. One would have thought of epiglotitis, but considering his age, epiglotitis wouldn't have lasted for 5 months, so does aspiration of a foreign body. It can not be persistent immaturity of lungs, the child was born at 37th week. Allergic reaction to cow's milk would not have been from birth. Alibism

[ArchivalUser]

I would like to agree with C, but not the guys.

[ArchivalUser]

Thanks ericz, I still make sense to you

[ArchivalUser]

vascular ring is the answer it compresses the trachea and congenital.

if it was not congenital and age being 1yr like fb could be thought of

if epiglootis all those drooling and positional stuff

if croup barkin cough and upprtract stridor thing

look at the intresting thing now ther is moderate relief in extention

[ArchivalUser]

i think it is foriegn body as a vascular anamoly of the trachea would produce stridor and not wheezing, alergic to cows milk should respond to steroid,so april 17 is foregin body the right ans....i think i cant leave the forum...

[ArchivalUser]

'she' I see you are addicted to the forum. We have already given you farewell. We are happy to have you back. Now back to the answer you gave.... this condition started at birth and the child is 5 months now. Doc 'She' it is a malpractice to allow the foreign body to persist in a child for 5 months. You must have a good lawyer and a heavy purse... Just kidding. Alibism

[ArchivalUser]

Welcome back She ) Do u miss us ))