Max is a 10 year old boy who presents to the Emergency Department with a two day history of anorexia, loose stools x3, pain that started in umbilical area and settled in the right lower quadrant.

Max is a 10 year old boy who presents to the Emergency Department with a two day history of anorexia, loose stools x3, pain that started in umbilical area and settled in the right lower quadrant.

Max is a 10 year old boy who presents to the Emergency Department with a two day history of anorexia, loose stools x3, pain that…

Max is a 10 year old boy who presents to the Emergency Department with a two day history of anorexia, loose stools x3, pain that started in umbilical area and settled in the right lower quadrant.

Max is a 10 year old boy who presents to the Emergency Department with a two day history of anorexia, loose stools x3, pain that started in umbilical area and settled in the right lower quadrant. He started feeling a bit better so mum encouraged clear fluids and gave him Paracetamol for fever to 38.4. He was admitted to the ward later the same day and was noted to have a fever of 39.6, diffuse abdominal pain and abdominal distension.
His blood tests taken on admission also reveal an elevated WBC. Physical Examination: T 39.6, P 110, RR 24, BP 95/65, oxygen saturation 99% in room air. Heart rate is regular and no murmurs are heard. He is lying in bed with his legs drawn up and is very anxious when you try to palpate his abdomen. His pain score using a numerical scale is 7/10.
Potential Diagnoses: Gastroenteritis, Viral illness, Appendicitis, UTI
The assignment should incorporate responses to the following:
• Discuss the child’s presenting condition in detail. Include:
1. Identify your ‘working diagnosis’ –
2. what is the most likely diagnosis – provide a rationale for your choice o
3. Discuss the signs and symptoms & diagnostic tests needed to confirm the diagnosis

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