Sample interview questions: How do you assess and manage patients with Kawasaki disease?
Sample answer:
1. Assessment:
- Detailed History:
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Ask about fever, rash, conjunctivitis, swollen lymph nodes, mucous membrane changes (red, dry lips, strawberry tongue), and extremities changes.
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Physical Examination:
- Look for:
- Fever
- Rash: Erythema and edema of hands and feet, trunk, and perineum.
- Conjunctivitis: Red, irritated eyes.
- Swollen lymph nodes: Especially cervical.
- Mucous membrane changes: Dry, red lips, strawberry tongue.
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Extremities changes: Swelling, erythema, and tenderness.
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Laboratory Tests:
- Complete blood count (CBC): Leukocytosis, thrombocytosis, and anemia.
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP): Elevated.
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Urinalysis: Proteinuria, hematuria, and pyuria.
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Echocardiogram:
- Look for:
- Coronary artery dilation
- Valvular regurgitation
- Myocarditis
2. Management:
- Immediate Treatment:
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Intravenous Immunoglobulin (IVIG): High-dose IVIG is the mainstay of treatment. It reduces inflammation and prevents coronary artery complications.
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Aspirin:
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High-dose aspirin is used to reduce inflammation and prevent thrombosis.
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