ANAK GNAPS

Summary

In this medical dialogue, Dr. Evi evaluates a 10-year-old patient, Mr. Dewa, who has been experiencing red-colored urine for four days. The doctor conducts a thorough examination, including a review of the patient’s history and physical checks, revealing signs of possible acute post-streptococcal glomerulonephritis. The diagnosis is confirmed with supporting tests, including urinalysis and an elevated ASTO titer. Dr. Evi discusses the diagnosis, possible treatments, including antibiotics and antihypertensive medications, and recommends hospitalization for further monitoring. The overall tone is caring and professional, with an emphasis on patient care and follow-up.

Takeaways

• 😀 Dr. Evi introduces themselves as the doctor on duty, preparing to examine a 10-year-old child named Dewa who has a red urine complaint.
• 😀 The child’s urine has been red for the past 4 days, with a decrease in frequency of urination to once a day. No complaints of pain or discomfort were reported.
• 😀 The child’s family has no history of similar complaints, hypertension, or diabetes. The child had a sore throat about two weeks ago, but no other major health issues.
• 😀 The child has completed their immunization schedule, and there are no known drug allergies.
• 😀 Dr. Evi performs an anthropometric examination, measuring the child's weight (33 kg) and height (137 cm).
• 😀 Vital signs are taken, showing high blood pressure (140/90 mmHg), a heart rate of 96 bpm, respiratory rate of 24 breaths/min, and a normal temperature of 37°C.
• 😀 Dr. Evi conducts a thorough head-to-toe physical examination, noting no significant abnormalities in the eyes, mouth, or lymph nodes.
• 😀 The thorax and abdominal examination reveal no significant issues, with normal findings in the heart and lungs. No pain was reported during the abdominal examination.
• 😀 Extremities are examined, showing normal circulation and no signs of edema or cyanosis.
• 😀 The supporting test results show leukocytosis (high white blood cell count) and erythrocytes in the urine, suggesting a kidney issue. The ASTO titer was 300, indicating a recent streptococcal infection.
• 😀 Based on the findings, Dr. Evi diagnoses the child with acute post-streptococcal glomerulonephritis, recommending hospitalization for monitoring, antibiotic treatment, and antihypertensive medication. A pediatrician consult is suggested for further care.

Q & A

What is the main medical concern for the child in the transcript?

The child is presenting with red-colored urine for the past four days, which is indicative of a possible kidney condition, specifically acute post-streptococcal glomerulonephritis (APSGN).

What are the significant symptoms observed in the child?

The child has red urine, decreased frequency of urination (only once a day), and no reported pain or discomfort during urination. These symptoms suggest a renal issue, specifically glomerulonephritis.

What could be the cause of the child’s condition?

The condition is likely caused by a previous streptococcal infection, which often leads to post-streptococcal glomerulonephritis. This can be triggered by either a throat or skin infection.

How did the doctor assess the child’s health during the examination?

The doctor conducted a thorough physical examination, including measuring vital signs (blood pressure, heart rate, respiratory rate, temperature), and an anthropometric examination (weight and height). A head-to-toe assessment was done to check for any abnormalities in the eyes, mouth, neck, thorax, abdomen, and extremities.

What were the child’s vital signs during the examination?

The child’s vital signs were: blood pressure 140/90 mmHg, heart rate 96 bpm, respiratory rate 24/min, temperature 37°C. These findings suggest the presence of hypertension, which is concerning in the context of the kidney condition.

What was the significance of the supporting examinations like the urinalysis and CBC?

The urinalysis showed red urine, erythrocytes, and protein, which are indicative of kidney inflammation. The CBC showed leukocytosis with elevated neutrophils, suggesting an ongoing infection. These findings support the diagnosis of acute glomerulonephritis.

What is the diagnosis based on the examination results?

The diagnosis is acute post-streptococcal glomerulonephritis, confirmed by the child’s red urine, elevated ASO titer, and abnormal urinalysis results (protein and erythrocytes in the urine).

What are the differential diagnoses considered by the doctor?

The differential diagnoses include nephrotic syndrome and other nephritic syndromes, as they also present with similar symptoms like proteinuria and hematuria.

What treatment is being prescribed for the child?

The child will be treated with antibiotics to address the streptococcal infection, antihypertensive medication to manage high blood pressure, and hospitalization is recommended for regular monitoring of the child's condition and lab results.

What lifestyle and dietary recommendations were given to the family?

The family is advised to ensure the child gets plenty of rest and adjust the child’s diet to support recovery. Additionally, the child’s treatment will be closely monitored by a pediatrician.