Next visit

You have been invited to the gastroenterology clinic by the specialist to join the consultation with Davina and her parents. You explain the course of events that led to the referral. The consultant listens, and explains that it is a difficult diet to follow for young children and their parents. The time that it is introduced also is at the same time as food fads and eating behavioural problems are common, adding to the difficulty. If there is absolute certainty about the diagnosis, it is easier to be clear and directive. Without a biopsy, you cannot be certain.

You also mention that Davina’s mother seems quite emotional about having to use formula milk as opposed to breast feeding her daughter. The consultant explains that, with children, and especially with diet advice, understanding and working with parents is essential to develop a good therapeutic relationship.

Davina’s parents are told about the importance of the diet and the need for a biopsy. They understand this, but are confused that this was not made clear before. They ask if it would not just be better to really stick to the diet and thereby avoid the biopsy.

Two weeks later you see Davina again with her parents in the gastroenterology clinic with the specialist.

The procedure went well, although Davina’s parents report that she was frightened before she went to sleep.

The biopsy results are back now and show that she has villous atrophy in the duodenal and jejunal specimens that were taken. This confirms that she has coeliac disease.

Her parents had been expecting this and are pleased that this is now clear. However they are annoyed by the delay and point out that the hospital could have got to this point at months earlier. Meanwhile, she has not been growing for this time and effectively lost 2 months of growth.

The gastroenterologist agrees, and then takes them back to the dietician. Some iron and vitamin supplements are also prescribed.



Map: TAME Case 4 - Davina (Tutorial 1) (324)
Node: 8037
Score:

reset

OpenLabyrinth
OpenLabyrinth is an open source educational pathway system

Review your pathway

  • Živela bi v koči, v gozdu.
  • A atividade é uma encenação.
  • Assistenten forklarer at hun har ofte reagert ikke så pedagogisk mot barna og ønskes å få veiledning både fra meg og styren
  • Έκβαση περιστατικού
  • A atividade é cozinhar.
  • Diagnosis established.
  • Βλέπεις τον ιατρικό της φάκελο
  • Ακτινολογικός έλεγχος του σκελετού
  • O Costas e o pai brincam juntos.
  • Gjør og sier ingenting mer. Det er ikke mitt problem måten at hun oppfører seg
  • Assistenten forsetter å oppføre seg på samme måte og viser at hun har ikke forstått saken
  • Jeg forklarer foreldrene at jeg tar opp saken med assistenten så fort så mulig
  • Costas e o pai discutem.
  • A atividade é pintura.
  • Det kommer klaging fra foreldrene som har observert henne ved henting og bringing situasjon
  • Assistenten forklarer at hun har ofte reagert ikke så pedagogisk mot barna og ønskes å få veiledning både fra meg og styren
  • Styren tar over saken og bestemmer i samarbeid med meg at assistenten får oppfølging og veiledning fra styren og meg ukevis
  • Snakker jeg med styrer om dette
  • Tar jeg den opp på neste avdelingsmøtet
  • Testul difenilaminei
  • Ώσμωση
  • Στο γραφείο του οικογενειακού ιατρού
  • Jeg merker at resten av personalet stopper å snakke når jeg kommer inn på pauserom. Når jeg tar det opp på avdelingsmøtet, resten av personalet på avdelingen reagerer negativt mot meg og sier at det e
  • Proteinasa K
  • Observing the wrong section of the tip
  • Observation under the microscope (animal cell)
  • Results
  • Testul Biuret
  • MSA
  • Alelos
  • US examination
  • Pine tree cones
  • Ρωτάμε περισσότερες πληροφορίες
  • Costas is the father.
  • Revenind din parc, tatăl i-a spus că viața continuă și că ar trebui să rămână puternici.
  • Prostaglandin
  • Objective examination
  • BEGIN SCENARIO
  • Call consultant
  • Proceed to thorax CT.
  • Jonah is 30 years old and lives with his mother in Thessaloniki.
  • A higher magnification is needed to observe the cells
  • Deflate the cuff at 5-10mmHg per second
  • Λάθος!
  • Digestia ADN-ului cu endonuclează de restricție: Selectarea enzimei potrivite
  • Vor locui într-o barcă.
  • Ei vor cumpăra o mașină.
  • He says goodbye to her.
  • Un microscop care folosește o sursă de electroni pentru a mări obiectele
  • Proceed to thorax CT.
  • (1) prophase, (2) interphase, (3) telophase, (4) prometaphase, (5) anaphase and (6) metaphase
  • Next visit

Reminder

empty_reminder_msg

FINISH

Time is up