This is an INDIVIDUAL activity, 1 case is assigned per person, submit your answers

tomorrow in 1 page of short bond paper only. Prepare a power point for your case and be
prepared to report your case tomorrow. Reporters will be called randomnly.

FOR CASE # 1 : SECTION A REPORTERS/MEMBERS OF GROUP 1, 4 AND 7.

SECTION B REPORTERS/MEMBERS OF GROUP 1 AND 4.

FOR CASE # 2: SECTION A REPORTERS/MEMBERS OF GROUP 2 AND 5.

SECTION A REPORTERS/MEMBERS OF GROUP 2 AND 5.

FOR CASE # 3: SECTION A REPORTERS/MEMBERS OF GROUP 3 AND 6.

SECTION A REPORTERS/MEMBERS OF GROUP 3 AND 6.

CASE 1
An 18 month old boy is brought to the emergency room by police for evaluation. He and his siblings were
all removed from their home earlier in the day, after a neighbor's complaint. There are no parents or
guardians present to give a history, although the police officer comments that the mother is thought to be
an injection drug user. The 12 year old sister, who seems to be the primary caregiver, is worried that the
toddler is sick, stating that "he's gotten really skinny" and he "keeps a cold," with constant rhinorrhea and
cough. She is unsure if he has seen a doctor, but thinks that he "got all his baby shots".

Diet history revealed that meals are generally prepared by the 12 year old and 10 year old siblings, and
consist of cup noodles and usually drink juice and sodas, though the toddler also drinks some milk.

On exam, the toddler is anxious, clinging to his older sister. He appears thin, with a large head and
subcutaneous wasting. Vital signs are appropriate for age. Weight is 6 kg; height is 68 cm; head
circumference is 47 cm. Exam is significant for subcutaneous wasting, sparse hair, dry skin, and a scaling
rash in the diaper area. There are no overt signs of trauma, and no focal neurologic deficits.

QUESTIONS:
1. Enumerate the pertinent data/signs/symptoms of the case.
2. What is the ideal body weight, height and head circumference of this child?
3. Compute for the weight for age, height for age, weight for height and interpret the data using the:
a. Gomez Classification
b. Wellcome Classification
c. Waterlowe Classification
4. Give at least 5 consequences of undernutrition.
5. How would you investigate this child?
6. What laboratory tests/diagnostics would you request?
7. What are the expected Lab findings in this case?
8. How would you treat this child?
a. Make an initial 7 days, day-to-day/daily plan of management for this patient.
b. After the 7 days treatment, what will be your next plan of action.

CASE 2
A 2-year-old boy has recently had measles infection, complicated by diarrhoea but no vomiting. He
presents with a 1-week history of edema initially of the feet, then legs, but now extending to the hands. He
has sore eyes and photophobia. His weight is 7 kgs and length of 70 cms. He will not open his eyes and
has a corneal ulcer.
QUESTIONS:
1. Enumerate the pertinent data/signs/symptoms of the case.
2. What is the ideal body weight and height of this child?
3. Compute for the weight for age, height for age, weight for height and interpret the data using the:
a. Gomez Classification
b. Wellcome Classification
c. Waterlowe Classification
4. Give at least 5 consequences of undernutrition.
 5. How would you investigate this child?
6. What laboratory tests/diagnostics would you request?
7. What are the expected Lab findings in this case?
8. How would you treat this child?
a. Make an initial 7 days, day-to-day/daily plan of management for this patient.
b. After the 7 days treatment, what will be your next plan of action.

CASE 3
8 months old, male referred to the hospital for faltering weight for the past 3 months and cough of 2 weeks
duration. Birth weight was 3.5kgs, highest weight attained was 7 kgs at 5 months old, present weight is
6kgs. Dietary history revealed that the child was exclusively breastfed for 3 months only and was then
started on semi-solids. He was introduced to water and plain rice porridge with occasional mashed banana
and potatoes of about cup per meals at 3-4 times per day. The child developed cough 2 weeks prior
with low grade febrile episodes. No consult was done and no medications given Worsening cough
prompted his mother to take the child to a health center. No immunization received. Currently can sit with
support, crawls occasionaly prior to illness. On PE, weight is 6 kgs, length of 68cms. The patient is awake
and apathetic. BP 100/70 HR 120bpm RR 50cpm Temp 370C., pale conjunctivae, anicteric sclerae, no
chest retractions, (+) crackles on both lung fields. There is desquamating dermatitis, particularly on the
lower legs, where there is pitting oedema. He has 3 cm hepatomegaly.
QUESTIONS:
1. Enumerate the pertinent data/signs/symptoms of the case.
2. What is the ideal body weight and height of this child?
3. Compute for the weight for age, height for age, weight for height and interpret the data using the:
a. Gomez Classification
b. Wellcome Classification
c. Waterlowe Classification
4. Give at least 5 consequences of undernutrition.
5. How would you investigate this child?
6. What laboratory tests/diagnostics would you request?
7. What are the expected Lab findings in this case?
8. How would you treat this child?
a. Make an initial 7 days, day-to-day/daily plan of management for this patient.
b. After the 7 days treatment, what will be your next plan of action.