Junaidah Has A Sore Foot

This week's look complicated... Oh well.

The Case:
Name: Junaidah
Gender: Female
Age: (Likely) 13 years old
Occupation: Student
Address: Sabak Bernam

History of Present Illness
What: A persistent, non-healing sore on foot
When: N/A
Where: Foot (which foot is unspecified)
Quality: Sore (unspecified)
Quantity: N/A
Aggravating factors: N/A
Alleviating factors: N/A
Associated symptoms: Starting to smell bad
Beliefs: (Likely) spina bifida

Medical & Surgical History
What: Lumbosacral myelomeningocoele
When: Upon delivery (childbirth)
Where: L5/S1 region
Cause: Spina bifida
Management: Neonatal surgery (unspecified)













Associated complications: Hydrocephalus days after operation
Management: Insertion of ventriculoperitoneal shunt 2 weeks later













Details of the Pregnancy & Birth
Overview: Born at full term
Complications: None
Prenatal Considerations: Folate & iron supplement 16 weeks into pregnancy

Social Considerations
Barriers to Access: Time, cost & distance factors
Quality of Life: Trouble in school (work & relationships)

Physical & Neurological Examinations
Normal:

• Hip flexion
• Knee extension

Abnormal:

• Knee flexion (weak) - Hamstrings, L5/S1
• Loss of peripheral sensation in soles of foot (tickling & pain induction) - S1

Possible hyperalgesia:

• Outer thighs (cried on injection) - (likely) L1/L2/L3

Think Tank
Folic acid is actually said to be protective against spina bifida - Was it just plain bad luck?

Resource list
Neural Tube Defects: 1, 2
Spina Bifida (General): 1, 2
Radiology: 1
Spina Bifida & Folic Acid: 1, 2, 3 (3rd is on Neural Tube Defects in general)
Myelomeningocoele: 1, 2, 3, 4
Ventriculoperitoneal Shunt: 1, 2, 3
Hydrocephalus: 1, 2
Extrapolated Statistics for Spina Bifida: 1
Neurology of Newborn (GoogleBooks): 1
Malaysian Children with Spina Bifida: Relationship Between Functional Outcome and Level of Lesion: 1

That's all I have. & I probably missed plenty, as usual. :3