Lin, a 5-year-11-month-boy, had a fever 20 days ago with no obvious trigger and reached the highest oral temperature of 40°C. He was suspected to have EBV infection and mononucleosis at first. He then visited a pediatric hospital and the results show no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). The liver and spleen was palpable 1.0cm below rib with a soft texture, tenderness (-) and rebounds tenderness (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness. Blood routine test: WBC: 7.2 X 10"/L, RBC: 3.1 X 10/L, BPC: 64 X 10/L, Hb: 90g/L, atypical cells 7%. Peripheral blood smear test: blast=18%, L-48%, N=31%. The physician suggested Lin have an EEG, head CT scan and abdominal B ultrasound. The physician also talked with the family again to suggest a lumbar aspiration for further diagnosis. At the same time, the physician re-examined Lin's blood routine and peripheral blood smear. 1. Why Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-) but Lin still needs to take EEG, head CT scan, abdominal B ultrasound and lumbar aspiration? 2. Why the doctor needs to re-examine his blood test?
Lin, a 5-year-11-month-boy, had a fever 20 days ago with no obvious trigger and reached the highest oral temperature of 40°C. He was suspected to have EBV infection and mononucleosis at first. He then visited a pediatric hospital and the results show no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-). The liver and spleen was palpable 1.0cm below rib with a soft texture, tenderness (-) and rebounds tenderness (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness. Blood routine test: WBC: 7.2 X 10"/L, RBC: 3.1 X 10/L, BPC: 64 X 10/L, Hb: 90g/L, atypical cells 7%. Peripheral blood smear test: blast=18%, L-48%, N=31%. The physician suggested Lin have an EEG, head CT scan and abdominal B ultrasound. The physician also talked with the family again to suggest a lumbar aspiration for further diagnosis. At the same time, the physician re-examined Lin's blood routine and peripheral blood smear. 1. Why Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-) but Lin still needs to take EEG, head CT scan, abdominal B ultrasound and lumbar aspiration? 2. Why the doctor needs to re-examine his blood test?
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
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Transcribed Image Text:Lin, a 5-year-11-month-boy, had a fever 20 days ago with no obvious trigger and reached
the highest oral temperature of 40°C. He was suspected to have EBV infection and
mononucleosis at first. He then visited a pediatric hospital and the results show no anaemic
face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged. Skin rash (-).
The liver and spleen was palpable 1.0cm below rib with a soft texture, tenderness (-) and
rebounds tenderness (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's
sign (-). All joints had no swollen and tenderness.
Blood routine test: WBC: 7.2 X 10°/L, RBC: 3.1 X 10/L, BPC: 64 X 10°/L, Hb: 90g/L,
atypical cells 7%. Peripheral blood smear test: blast=18%, L=48%, N=31%.
The physician suggested Lin have an EEG, head CT scan and abdominal B ultrasound. The
physician also talked with the family again to suggest a lumbar aspiration for further diagnosis.
At the same time, the physician re-examined Lin's blood routine and peripheral blood smear.
1. Why Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-) but Lin still needs to take EEG,
head CT scan, abdominal B ultrasound and lumbar aspiration?
2. Why the doctor needs to re-examine his blood test?
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