Photos, facts and fibs... Minor problems
Vol.18, No.08, September 2010

This quiz is just for fun. Test your diagnostic skills with the photos, then separate truth from fiction in the statements about methylphenidate and ileostomy. Any of the statements below might be true… and any might just be us pulling your leg. Answers are below.

1. Each of the pictures below comes with a symptom clue. Match the pictures to the following conditions:

1) Measles

2) Chickenpox

3) Hand, foot and mouth disease

4) Fifth disease

5) Molluscum contagiosum

6) Hives

7) Impetigo

8) Miliaria crystallina

9) Miliaria rubra

10) Penicillin serum sickness reaction

2. Methylphenidate (Ritalin)

True or False

a) Early lost growth is usually regained by late teens.

b) Therapy normally raises blood pressure and heart rate.

c) Common side effects are nervousness, insomnia, and appetite suppression.

d) Due to the drug’s rapid absorption, children must take a second dose during the school day.

f) Has been shown to increase risk of substance abuse disorders.

3. Ileostomy

True or False

a) External ileostomies are rarelydone today as they’re beingreplaced by newer techniques like the Barnett continent reservoir and J-Pouch.

b) The discharge is corrosive.

c) The patient should be advised to avoid drinking milk or eating yoghurt.

d) The patient should be advised to take extra salt and water after exercise.

e) Over time, the patient can learn to control the discharge.

ANSWER

1. Minor problems a) Penicillin serum sickness reaction; b) Miliaria crystallina; c) Hives; d) Hand, foot and mouth disease; e) Impetigo; f) Miliaria rubra; g) Measles; h) Molluscum contagiosum; i) Chickenpox; j) Fifth disease.

2. Methylphenidate (Ritalin): a) False, the effect flattens out later on, but the lost growth is not regained, and children finish shorter; b) True, heart rate rises by about 3-5 bpm, systolic BP by 2-4 mm Hg, and diastolic by 1-3 mm Hg; c) True; d) False, sustained-release tablets can last through the school day; e) False, ADHD increases risk of substance abuse disorders, methylphenidate treatment has been shown to reduce SUD risk in patients with ADHD.

3. Ileostomy: a) False, the J-Pouch procedure typically involves creating a temporary ileostomy to divert stool while the pouch heals; b) True; c) False, there are no absolute restrictions of any food or drink, but patients should experiment first with small amounts; d) True; e) False, the discharge will always be beyond the patient’s control.

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