A seven-week-old infant was born with a biliary atresia. The…
A seven-week-old infant was born with a biliary atresia. The patient has severe obstructive jaundice due to the congenital condition. The patient was admitted and the diagnosis is confirmed by surgical exploration with an operative cholangiography done under fluoroscopic guidance with low osmolar contrast (this included views of the gallbladder and bile ducts). The biliary atresia is treated with a Roux-en-Y operation in the hepatobiliary system, also known as the Kasai procedure, where the pediatric surgeon removes blockage in the gallbladder and bile ducts outside the liver and uses part of the small intestine to replace it. As a result, the bile will flow directly from the liver into the small intestine. The surgeon explained to the parents the operation does not cure biliary atresia but it does produce near normal bile flow and corrects problems that result from the bile obstruction. Otherwise, a liver transplant is the only cure for biliary atresia. For this patient, the Roux-en-Y bypass was created from the gallbladder to the small intestine. Principal Diagnosis: Secondary Diagnosis: Principal Procedure: Secondary Procedure:
Read DetailsThe patient was admitted from home on May 31 with vaginal bl…
The patient was admitted from home on May 31 with vaginal bleeding. This is the patient’s third admission to labor and delivery during this pregnancy. The patient is 33 years old, gravida 1, para 0, with 34 completed weeks of gestation, with an estimated date of confinement of July 9. She has twin gestation (two placentae and two amniotic sacs) and complete placenta previa. Because of this last episode of bleeding, it was decided to keep her at bed rest in labor and delivery at the hospital so that, should any further excessive bleeding occur, she would be available for emergency cesarean delivery, if necessary. The intent was to keep her until she reached 36 weeks gestation as recommended by the perinatologist in consultation. On June 10 she had bright red bleeding from the vagina. There were contractions of preterm labor noted affecting both fetuses. Because she was one day short of 35 weeks gestation, it was decided to go forward with a primary low cesarean delivery for the incomplete or partial placenta previa with hemorrhage. She delivered a 4 lb, 9 oz viable female with Apgar scores of 8 and 9 at 16:01 p.m. She delivered a 4 lb, 15 oz viable male with Apgar scores of 7 and 9 at 16:02 p.m. Intraoperative blood loss was approximately 1 liter. She was anemic due to acute blood loss prior to surgery. She had a good recovery from the surgery and her hemoglobin stabilized at 8.2 gm. She was discharged home to follow up in the office in two weeks for an incision check. Her twin infants remained in the premature nursery for further treatment. Principal Diagnosis: Diagnosis: Diagnosis: Diagnosis: Diagnosis: Diagnosis: Diagnosis: Diagnosis: Hint: There are NO extra blanks. Principal Procedure:
Read DetailsWrite these answer son a separate sheet 7. What is th…
Write these answer son a separate sheet 7. What is the major organic product/s obtained from the following reaction? (2 points) 11. What is the major organic product obtained from the following reaction? (1 point) 6. Provide the structures of the sodium alkoxide and the alkyl iodide that would be the best starting materials for the preparation of the following compound by a Williamson ether synthesis. (2 points)
Read DetailsThe patient was admitted in active labor, 38 weeks gestation…
The patient was admitted in active labor, 38 weeks gestation. The patient has multiple sclerosis which has been exacerbated by the pregnancy. The patient delivered a liveborn female infant in the delivery room over a midline episiotomy without complication. Principal Diagnosis: Diagnosis: G35 (this is the code for the multiple sclerosis—the principal diagnosis is an O code) Diagnosis: Diagnosis: Principal Procedure: Procedure:
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