| Epocrates

By vgreene, 7 April, 2020

Randomized Study to Evaluate the Safety and Antiviral Efficacy of Hydroxychloroquine in Patients With Newly Diagnosed COVID-19 Compared to Standard of Care Treatment, NCT04334967

(BMJ)—An 8-yo girl presented w/ a 4-wk hx of puffy eyes following a viral URI. Her mother noticed the child’s pants were too tight and her L arm was swollen. Exam: generalized edema; L arm swollen, cool, and dusky. Labs: CRP normal. UA: + protein, + blood. BUN elevated. Albumin decreased. Cholesterol elevated. What is the dx?

Nephrotic syndrome

Paget-Schroetter syndrome

Upper extremity DVT

Subclavian artery stenosis

Allergic reaction

You are correct. Nephrotic syndrome presents as a triad of proteinuria, low albumin, and peripheral edema, w/ or w/o hyperlipidemia. DVT was considered because of the coolness and dusky appearance of the L upper limb on clinical exam. Doppler U/S was negative for DVT, however, and the appearance of the limb was attributed to capillary stasis caused by limb edema. The pt went into remission w/ steroid tx after 6mo and will remain under specialist pediatric nephrology f/u for 24mo.

BMJ 2020;368:l5988

By vgreene, 4 April, 2020

SNF

By vgreene, 4 April, 2020

Pedi sx may be milder than adults; 16%-45% may be w/o sx.1 Cough, fever most common; signs/sx may mimic other pedi illnesses (eg, flu, strep throat, allergic rhinitis)

By vgreene, 3 April, 2020

Advise wearing cloth face coverings in public settings

By vgreene, 3 April, 2020

Rationale: SARS-CoV-2 virus can spread between people interacting in close proximity (eg, speaking, coughing, sneezing), including among asymptomatic and pre-symptomatic individuals

By vgreene, 3 April, 2020

Coverings made from household items or other low-cost materials can be used, but surgical masks and N95 respirators should be reserved for health care workers or first responders

By vgreene, 3 April, 2020

CDC recommends that all people wear cloth face coverings in public settings where other social distancing measures are difficult to maintain (eg, grocery stores, pharmacies); 6-feet social distancing remains important and should be used in conjunction w/

By vgreene, 3 April, 2020

Advise wearing cloth face coverings in public settings

By vgreene, 3 April, 2020

Rationale: SARS-CoV-2 virus can spread between people interacting in close proximity (eg, speaking, coughing, sneezing), including among asymptomatic and pre-symptomatic individuals

Randomized Study to Evaluate the Safety and Antiviral Efficacy of Hydroxychloroquine in Patients With Newly Diagnosed COVID-19 Compared to Standard of Care Treatment, NCT04334967

SNF

Pedi sx may be milder than adults; 16%-45% may be w/o sx.1 Cough, fever most common; signs/sx may mimic other pedi illnesses (eg, flu, strep throat, allergic rhinitis)

Advise wearing cloth face coverings in public settings

Rationale: SARS-CoV-2 virus can spread between people interacting in close proximity (eg, speaking, coughing, sneezing), including among asymptomatic and pre-symptomatic individuals

Coverings made from household items or other low-cost materials can be used, but surgical masks and N95 respirators should be reserved for health care workers or first responders

CDC recommends that all people wear cloth face coverings in public settings where other social distancing measures are difficult to maintain (eg, grocery stores, pharmacies); 6-feet social distancing remains important and should be used in conjunction w/

Advise wearing cloth face coverings in public settings

Rationale: SARS-CoV-2 virus can spread between people interacting in close proximity (eg, speaking, coughing, sneezing), including among asymptomatic and pre-symptomatic individuals

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