A 13-year-old boy was riding his bicycle two days ago when he began to have sharp, pleuritic pain in his right chest. He has no shortness of breath or fevers. He has no past medical history, but on a review of systems he reports a two-month history of back pain with “good days and bad days”. Although he had mentioned it to his parents in passing some time ago, there appear to be some distracting social stressors in the family.
His vital signs are normal, and when you examine him you see this:
His vital signs are normal, and when you examine him you see this:
As you consider your differential diagnosis, you try to ask the correct screening questions.
Which of the following has NOT been validated as a screening measure in US children?
A. Has a family member or contact had tuberculosis disease?
B. Has a family member had a positive tuberculin skin test result?
C. Has your child complained of a prolonged cough (longer than you thought to
be normal) or a cough with bloody sputum?
D. Was your child born in a high-risk country (countries other than the United
States, Canada, Australia, New Zealand, or Western and North European
countries)?
In the meantime, a few quotes –
“Man ought to be man and master of his fate; but children are at the mercy of those around them.”
– Sir John Lubbock (1834-1913), English educationalist and reformer
..and..
“I prefer to be called a fool for asking the question, rather than to remain in ignorance.”
– John Homans (1836-1903), US professor of surgery
Boston Medical and Surgical Journal 87:1 (1872)
Which of the following has NOT been validated as a screening measure in US children?
A. Has a family member or contact had tuberculosis disease?
B. Has a family member had a positive tuberculin skin test result?
C. Has your child complained of a prolonged cough (longer than you thought to
be normal) or a cough with bloody sputum?
D. Was your child born in a high-risk country (countries other than the United
States, Canada, Australia, New Zealand, or Western and North European
countries)?
In the meantime, a few quotes –
“Man ought to be man and master of his fate; but children are at the mercy of those around them.”
– Sir John Lubbock (1834-1913), English educationalist and reformer
..and..
“I prefer to be called a fool for asking the question, rather than to remain in ignorance.”
– John Homans (1836-1903), US professor of surgery
Boston Medical and Surgical Journal 87:1 (1872)
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