A 2-year-old girl is presented by her father who is concerned about a rash that appeared after a recent fever, as she was recovering.
During the examination, you observe numerous pink-red papules and macules (2-5 mm in size) spread across the trunk, which disappear when pressed. The child seems unaffected by them and appears healthy with regular vital signs.
What is the probable diagnosis?
Liam is a 6-year-old boy who visits you with his father complaining of dysuria, frequency, and fever. During the urine dip test, nitrites and leukocytes are detected. Liam has no known allergies and is in good health otherwise. You decide to prescribe trimethoprim (50 mg/5ml). His current weight is 20 kg. According to the BNF, the recommended dosage is 4 mg/kg trimethoprim twice daily. What volume will you instruct his father to administer?
A 7-year-old girl presents to your clinic with a blanching rash that started on her abdomen and chest before spreading to her neck, legs, and arms. The rash is rough and has a sandpaper-like texture. She reports feeling feverish with a temperature of 38.5 ºC, a sore throat, and nausea two days before the rash appeared. On examination, you note her tongue has a beefy, red appearance and prominent cervical lymphadenopathy. You suspect scarlet fever. The patient has no significant medical history and no allergies. Hospital admission is not necessary. What is the most appropriate management option in primary care?
A concerned mother brings her 12 day old daughter to your clinic. The baby has developed a scaly, yellowish patch on her scalp and the mother seeks your advice. Upon examination, you notice the patch located on the occipital area of the baby’s head, but she appears to be in good health otherwise. What would be the best course of treatment for this condition?
A father brings his 10-year-old daughter to the GP surgery with heel pain. It started two-weeks ago on both heels. The pain is localised to the heel and is worse following exercise and gets better on resting. There is no reported swelling, stiffness or redness. There are no other joint complaints. She is well in herself with no temperature symptoms, night sweats or weight loss. There is no history of trauma. She is an active child and plays for the soccer team at school.
On examination, her gait and range of movements of her ankle joints are normal. Her temperature is 37.2ºC. Apart from mild swelling over both heels, there is no redness on the heel or other swellings of the foot joints. There is no tenderness on palpation of the Achilles tendon and the plantar aspect of the foot. Pain is elicited on squeezing the sides of both heels.
What is the most likely diagnosis for this child?
A 7-year-old child is brought to the Emergency Department by his parents as he is experiencing worsening breathing difficulties. The child has a history of asthma and has been hospitalized twice before due to exacerbations. During the examination, the child’s oxygen saturation is at 90% on air, heart rate is 140 beats/minute, respiratory rate is 40 breaths/minute, and he is using accessory muscles to breathe. Additionally, he is having difficulty completing full sentences.
Which aspect of the child’s medical history indicates a potentially life-threatening exacerbation?
A father brings his twelve-year-old daughter to see you in your GP practice as she has been struggling with sports at school. She has been complaining of steadily worsening pain, which is vaguely located above her right knee, for the past two weeks. Her father says that this has been particularly upsetting for her as she has been trying to lose weight. She is systemically well otherwise. Examination of the right knee joint is normal as is neurological examination of the lower limbs.
What is the most crucial diagnosis to rule out?
A 3-month-old formula-fed baby, born at 37 weeks, has been experiencing symptoms of cow’s milk protein allergy for the past 2 weeks. The baby is increasingly unsettled around 30-60 minutes after feeds, with frequent regurgitation, ‘colic’ episodes, and non-bloody diarrhoea. Mild eczema is present on examination, but the baby’s weight remains stable between the 50-75th centile. The baby was started on an extensively hydrolysed formula, but there is still some persistence of symptoms reported by the parents. What is the most appropriate next step in managing this baby’s condition?
A 27-year-old woman who is 16 weeks pregnant attends her antenatal clinic appointment. During the consultation, she is advised to visit her GP for vaccination but cannot recall which vaccines were recommended. She has received all her childhood and school immunizations but has not had any vaccinations since becoming pregnant.
What vaccines should be offered to this patient?
A father brings his 3-month-old baby to the pediatrician’s office, reporting that the infant has been vomiting and regurgitating after every feeding with a cow’s milk-based formula. The vomiting is not forceful, and there is no unusual coloration with blood or bile. The baby doesn’t appear to be in significant distress, but the father has also noticed that the child has persistent diarrhea. The father had to switch to formula as the mother was unable to produce enough breast milk. He tried a soy milk-based formula on the advice of a friend, but it did not make any difference.
What would be the most appropriate course of action?