Diagnosis of Wallenberg's Syndrome
Wallenberg's Syndrome Diagnosis: Book Excerpts
Diagnostic Tests for Wallenberg's Syndrome: Online Medical Books
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Umbilicus – Single Umbilical Artery:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
- Developmental agenesis or hypoplasia
–No clear sex ratio
–Males more likely to have associated malformations
–Increased incidence in twins, either mono- or
dizygotic
–Increased incidence of placental anomalies
–More common in low birth weight infants
–More common in premature infants
-
Associated maternal factors
–Maternal diabetes
–Maternal epilepsy
–Toxemia
-
Intrauterine thrombosis of other umbilical artery
- Malformations are associated with SUA in 45% of cases
–Genitourinary (33%): Renal agenesis, dysgenesis, hypoplasia; ambiguous genitalia
–Musculoskeletal (37%): Clubfoot, vertebral anomalies
–Cardiovascular (30%): Patent ductus arteriosus, ventricular septal defect, dextrocardia
–Gastrointestinal (28%): Imperforate anus, tracheoesophageal fistula
–Respiratory (9%): Pulmonary hypoplasia (malformations due to disruption of blood flow), sirenomelia
- Chromosomal anomalies
–Trisomy 18
Workup and Diagnosis
-
History
–Prenatal tests such as amniocentesis with karyotype
–Twinning
-
Physical exam
–Dysmorphic facial features
–Anomalies with genitourinary, gastrointestinal, cardiac, musculoskeletal organ systems
–Neurologic signs associated with stroke (e.g., seizures)
-
Level II prenatal ultrasound with Doppler examination of umbilical cord
-
Examination of placenta and cord at delivery
–Examine closer to umbilical end of cord since vessels may merge close to placental insertion
-
Karyotype
-
Genetics consultation
-
Thrombophilia evaluation
–Factor V Leiden or antithrombin III deficiency
–Anticardiolipin or lupus anticoagulant
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Pica:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Begin by determining what substances the patient has been eating. If the patient has eaten toxic substances, such as lead, obtain a serum lead level. If the patient is a child, ask the parents to describe his eating habits and nutritional history. When did the child first display pica? Does he always crave the same substance? Is he listless or irritable?
Check the patient’s vital signs, noting especially bradycardia, tachycardia, or hypotension. Then inspect the abdomen for visible peristaltic waves or other abnormalities. Observe the hair, skin, and mucous membranes for changes, such as dryness or pallor.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Arterial Pulse Variants:
Differential Overview
(Field Guide to Bedside Diagnosis)
Phenomena
❑ Irregularly irregular pulse
❑ Asymmetric pulses
❑ Bounding pulse
❑ Bisferiens pulse
❑ Bigeminal pulse
❑ Pulsus alternans
❑ Pulsus paradoxus
❑ Thready pulse
❑ Pulsus parvus et tardus
❑ Narrow pulse pressure
Diagnostic Approach
Examine the pulse using the method of trisection: apply pressure until the pulse is maximal, and then vary pressure while concentrating on phases of the pulse.
Early Chinese medicine based diagnosis primarily on careful examination of the pulse. There were six sets of pulses, each connected with a specific part of the body and each believed to register even the subtlest physiological changes within it. The principal pulses were Fu, a light-flowing pulse like a piece of wood floating on water; Ch’en, a deeply impressed pulse like a stone thrown into water; Ch’ih, a pulse with three beats to one cycle of respiration; and Shu, a pulse with six beats to one cycle of respiration.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
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