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THERoyalPENTAGONReview Specialists Inc.2ndFloor R.G.Casas Bldg.886 España Blvd.Cor. G. Tolentino St., Sampaloc ManilaTel. No. (02) 309-9582ANSWER KEYIntegrated Management of Childhood IllnessesSituation 1:Elsa brought her 4 month old baby James to the health center for treatment ofcoughs and colds.1. In line with integrated care, the following principles must be ensured EXCEPTA. All sick children must examined for general danger signs.To indicate need for immediatereferralB. all sick children must be routinely assessed for major symptoms.2-5yrs: cough/difficultbreathing, diarrhea, fever, ear problems; infants 1 week to 2 mos.: bacterial infection anddiarrheaC. Only a limited number of carefully selected clinical signs are used, based on evidence of theirsensitivity and specificity to detect diseases.D. A combination of individual signs leads to a child’s diagnosis rather thanclassification of the condition
2.The following danger signs must be routinely checked in all children including James:(DANGER signs)1-convulsions2-lethargic or unconscious3-unable to drink or breastfeed4-vomits everything
3. This particular main symptom is considered one of the main causes of childhooddisability among low and middle income countries
4. The cut off rate for James’s fast breathing is
5. James has lower chest wall in drawing. This means.A. inward movement of bony structure of chest wall with inspiration (in a calm child)B. movement of the soft tissues of the ribs without involvement of the bony structure of the chestwall–inter-coastal indrawingC. harsh sounds when the child inhalesstridorD. noise heard when the child exhaleswheeze

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