EBHF Assignments for Week 12
Full Course Overview
Case-Based Written Assignments
Congratulations on your Week 11 Submissions. The Answers to Week 11 (Case 21 and Case 22) are posted here.
There are TWO questions this week for Week 12 (Case 23 and Case 24). The EBHF Program now requires all fellows to upload their assignments to our server using the simple link below. STARTING IN WEEK 11, we no longer permit the emailing of ASSIGNMENT ANSWERS. ASSIGNMENTS ARE ONLY ACCEPTED USING THE LINK BELOW.
If you choose to write your answer in a language other than English, that is perfectly fine (and highly encouraged), but please let us know the language chosen when you submit your answer.
***CLICK HERE TO DOWNLOAD PDF OF CASE 23 and CASE 24***
Case 23
Dalia is 3 years old and her parents are interested in discussing JAK inhibitors as possible treatment for Dalia before she starts school.
Dalia was born at full term. At birth, her parents describe she had normal hair but it was lost starting around 1 month including eyebrows and lashes. By age 7 months, it was all gone. Dalia does not have any hair now.
Dalia started to walk at 11 months but thereafter her motor development slowed. At 18-24 months deformities of the lower limbs were noted. Her parents noted that x rays showed “loss of bone and a number of abnormalities”
Question for Case 23
1. Would you start a JAK inhibitor?
2. What treatment would you start?
**** Please upload your answers to the EBHF server and do not email*****
Case 24
Mala is 13 years old her parents are interested in discussing JAK inhibitors as possible treatment for their daughter. Mala has no scalp hair at the moment. Mala developed alopecia areata at age 9 and was treated with topical steroids and topical minoxidil and 2 courses of oral prednisone lasting 2 months each at age 11 and 12.
Mala is 147 cm (4 ft 10 in) and weighs 35 kg (77.2 pounds).
She has not had her period yet (first menstrual cycle). Mala’s mother said that they took her to a pediatric endocrinologist who x-rayed her hands and wrists and did many, many blood tests. Mala’s father says that the x-ray showed that “there is a lot of growing left to do.”
Mala’s father is 5 ft 10 in and Mala’s mother is 5 ft 6 inch.
Lab results are shown here:
Questions for Case 24
What is Mala’s current SALT score?
What does Mala’s father mean when he says that an x-ray of the hands and wrists was taken?
Using the CDC growth chart below, what would you estimate is Mala’s current percentile for height and weight?
How tall do you think Mala might become when she is older?
Do you think prior hair loss treatments have permanently impacted her growth?
Mala’s mother says that she noted that Mala’s ALP was high. Mala’s mother read online about how high ALP can ean the liver is not working properly. She says Mala does get abdominal pains sometime. What would you tell Mala’s mother ?
How would you rate Mala’s vitamin D levels? Do you suspect giving vitamin D supplements will help her hair? How much will you recommend she take?
**** Please upload your answers to the EBHF server and do not email*****
