A 5-year-old boy is brought to the emergency room by his mother. He was playing on the monkey bars at the playground and fell off, landing on his right arm. He started crying and complained that his right elbow hurt. He is now reluctant to move the elbow and holds it slightly flexed and pronated with the forearm held against the abdomen. There is no tenderness, swelling, bruising or deformity at the elbow.
Which is the MOST LIKELY diagnosis?
A new mother brings her 14-day-old boy to see you and you carry out a clinical examination. She wants to know if there are any indications that her child may have an underlying condition.
What feature in this boy would be most suggestive of a high risk of a serious underlying problem?
A 4-year-old boy’s mother is worried about his foreskin not retracting. Ballooning of the foreskin occurs during urination, but the penis appears normal. What is the MOST PROBABLE diagnosis?
The parents of a 6-month-old baby have brought their child to see you due to ongoing problems with reflux.
The baby has been seen in paediatric outpatients and was started on ranitidine. You can see from the clinic letters that this was started at an initial dose of 1 mg/kg three times a day but to achieve symptom control it has been titrated to 3 mg/kg TDS. The higher dose seems to be controlling symptoms well.
The paediatricians have asked you to continue to prescribe the ranitidine at a dose of 3 mg/kg until they review the child again in four weeks time.
You weigh the child today and the current weight is 6 kg. Ranitidine oral solution is dispensed at a concentration of 75 mg/5 ml.
What is the correct dosage in millilitres to prescribe?
A young mother with a 4-month-old boy presents to your practice. Her sister has recently lost a baby due to sudden-infant-death syndrome (SIDS). She asks for the current advice on minimising the risk of SIDS in her own family.
Which of the following pieces of advice is most appropriate?
A 6-year-old boy presents with swelling under his arm. He was well until six days before, when he developed mild fever and malaise. Immunisations are up-to-date. No family history of note. The family have a pet kitten and there were visible scratches on his arm.
On examination the temperature is 37.8°C. He has a 2.5 cm smooth enlargement of a node in the right axilla. This is slightly red but not fluctuant. Otherwise there are no abnormalities to find.
What is the single most appropriate treatment?
In the newborn period, what condition necessitates surgical intervention?
You see a six-year-old girl one evening during your out of hours shift. She has become very sick quite suddenly, with a high fever, sore throat, and difficulty breathing.
When you examine her, she is sitting upright with her mouth open, and you observe that saliva is drooling down her chin. She has a soft stridor audible at rest.
What is the most probable diagnosis?
The practice pediatrician has seen several adolescents with orthopaedic abnormalities and is uncertain about their management. You have been tasked with creating a tutorial on the subject. Which of these adolescent orthopaedic abnormalities is MOST LIKELY to require active intervention? Choose only ONE option.
What could be the cause of stridor in a 6-month-old infant?