AB, 5 years old, male, Filipino, Roman Catholic, resides at Camotes Cebu city, came in due to

diarrhea

8 hours PTC, noted onset of loose bowel movement approximately 15 episodes of fully soaked
diapers. Stools were greenish-yellow, watery, foul smelling, mucoid, bloody. No other
associated symptoms such as fever and vomiting. Mother self-medicated with Zin sulfate
55mg/5ml 5ml OD PO with Oresol but afforded no relief.

1 hour PTC, noted persistence of diarrhea now associated with abdominal pain, thus led to
consult.

Mother is G2P1 (0011), 35 years old. Her 1st pregnancy had imminent abortion at around 24
weeks gestation, delivered NSD at home. In her present pregnancy, prenatal check-up was done
at 24 weeks at their LHC seen by a midwife. Urinalysis, CBC, STI screening and UTZ were
unremarkable. She had multivitamins and Folic acid with good compliance. No maternal
illnesses noted.

She delivered via CS due to transverse lie. She was referred to a tertiary hospital and was
attended by an OBGYNE. Baby was delivered safely with Apgar score of 9,9, BS of 39 weeks, and
BW 3000gms. They were eventually discharged after 3 days with no other complications.

Patient was exclusively breastfed for only 6 months and was mixed with formula milk
thereafter. Weaning was started at 6 months old mostly of rice porridge and vegetables.

Immunization at birth were given. Subsequent immunizations were taken at their LHC: DPT x 3,
OPV x 3, Hep B x 3, MMR x 1.

Growth and development is at par with age.

Heredofamilial diseases include hypertension and cardiac problems in the maternal side, and
Diabetes in the paternal side.

They live in a rented concrete housing. Patient’s father is 41years old and works as a
government employee, apparently healthy. Mother is unemployed and does most of the chores
at home. His older sibling is 10 years old, currently in 4 th grade and is also healthy. They get
their drinking water from purified refilling water stations however for the past week, water
source is from deep well boiled for 10mins.

Patient was seen awake, not in respiratory distress, with the following VS:
HR: 122cpm
RR: 25bpm
Temp: 36.6C
02 sat: 100% at room air
Weight: 25kg
Height: 105cm
MUAC: 11.5cm

Skin: no pallor, no cyanosis, no jaundice, good skin turgor

HEENT: Normocephalic, nonsunken eyes, nonsunken fontanels, dry lips and tongue, no alar
flaring
CL: CBS, ECE
CVS: adynamic precordium, distinct heart sounds, no murmurs
Abd: Soft, Normoactive bowel sounds, (+)tenderness hypogastric area
GUT: grossly male
Ext: SPP, CRT less than 2s

TASKS:
1. Present as Oral Case Presentation/Case Discussion
2. Give your differentials and primary Impression
3. Present your Discussion about the case

4 x 55 Liter of coke = 220

4 x Lechon manok = 960
Bam-e = 350
Ice cream= 450