Medical Information for Karla and Ana T.
from Mexico
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KARLA
Age: 11 years Old
DOB: December 29th, 1997
Schooling: 5th Grade
Diagnosis: Healthy
HISTORY:
Minor who is put at the disposition of the government authorities due to that her mother left her in the care of
her older sister who then brutally beat her.
MEDICAL DIAGNOSIS:
At her admittance:
She presents malnutrition and regular hygiene habits, with several bruises and excoriations on her skin in
several parts of her body.
In actuality:
The minor has recuperated from her malnutrition, and she actually behaves as a healthy girl up until this
moment.
PSYCHOLOGICAL DIAGNOSIS:
Minor who is admitted with social deprivation due to the abuse she suffered, very timid. Nonetheless, she has
achieved to adapt herself in the home where she is now and she begins to trust and is integrated to the daily
activities, adolescent which because of her age she is going through a stage of physical and emotional changes.
Which are understood and treated accordingly to her needs. She is average in school without conduct problems.
CONCLUSIONS:
Karla, due to the circumstances she is in she requires a well structured family, eager to give love, affection and
above all patience to face the stage of puberty she is going through. The minor is willing and open to have a
family, to which would be of great help to her person in all aspects.
NAME: ANA GABRIELA
AGE: 9 years old
DOB: September 22, 2000.
In 2006 this child is taken from her mother and maternal grandparents due to omission of care. At the time she
was admitted she presented malnutrition and deplorable hygiene conditions.
On February 12th, 2009 the final sentence was dictated where the state won the custody.
MEDICAL ASPECT
In October of 2006 the following medical tests were done, which report:
Parasitoscopy: Negative
In May of 2007:
Complete Hepatic Biometry: erythrocytes 4.82, hemoglobin 13.5, hematrocytes 38.8, platelets 270,000
HEPATITIS PROFILE: positive for hepatitis memory type B
In March 2009:
RH and Blood Group: O Positive
VDRL y HIV: Negative
COMPLETE HEMATIC BIOMETRY: Leucocytes 5,640, erythrocytes 4.9, hemoglobin 13.2, hemathrocytes 39.8,
platelets 266,000, the remaining within the normal parameters.
HEPATITIS PROFILE: Negative
GENERAL URINE TEST: Yellow, lig, murky, ph 5, density 1.020, sparse bacteria, leucocytes 0 to 2, low
epithelial cells 0 to 1 x c, all the remaining negative.
She is now reporting to be very healthy and practically she has not had infectious diseases, she has a normal
growth and development and without problems. Of the malnutrition she was suffering she is recuperated. Her
weight and statute are low according to her age and weight and height tables for girls between 6 and 18 of
National standard commission. As of December 2008, she uses glasses.
PSYCHOLOGICAL ASPECT
The minor has problems learning, she is not motivated to learn and is limited in school, she has poor motor
control, poor perception and lacks equilibrium.
In the aspect of affection, she is a girl who needs a lot of support, love and understanding, which in turn will help
her thrive and will enable her to adapt quickly to a family, reason why she is considered a candidate for
adoption. Because of her life history at this moment she is cautious when she interacts with adults, and very
observant before she can express her feelings openly.
It is perceived that she cannot manage herself adequately within her reality, creating conflict and feelings of
loneliness, anxiety and panic to the point of shutting off, she is insecure at times. She has the need to build a
family that would give her security and love; she idealizes so much a family that she resorts to fantasy, this is
because during the first stages of her life she didn’t have the maternal and paternal figures in an adequate way.
The paternal figures are necessary in her life because these will give her security and will help with her self
esteem, fortifying her and allowing improvement in the emotional and scholastic areas.