You see a 35-year-old male patient who is interested in starting a family with his partner. However, he is worried about the possibility of passing on a learning difficulty to his child. He mentions that his cousin has a learning difficulty that he believes is inherited. What is the most common cause of inherited learning difficulty that his cousin may have?
Sophie is an 8 month old baby girl who comes to you with inadequate weight gain (75th to 25th centile), during examination she has a blanching, erythematous rash on her abdomen, colicky abdominal pain and regurgitation after feeds. She has been breastfed with additional ‘Cow & Gate’ formula. What is the probable diagnosis?
A worried 30-year-old mother expresses concern about a lump that has emerged on her infant’s head, stating with certainty that it was not present at birth and was only noticed 45 minutes ago. The baby was delivered vaginally with forceps 10 hours ago at 39 weeks gestation.
Upon examination, there is a clearly defined, fluid-filled bump that doesn’t cross suture lines and is located on the parietal bone. The baby appears to be in good health otherwise, with normal skin color and tone, as well as regular vital signs.
What is the most probable diagnosis?
Following recent NICE guidelines on child maltreatment, which one of the following should prompt you to suspect child maltreatment, rather than just considering it:
Sophie is a 2-year-old girl who is brought in by her father. She has had a fever overnight, along with a sore throat and cough. Her father is worried that she seems more tired than usual today. During the examination, you note the following:
Temperature 38.5 degrees
Heart rate 160 bpm
Respiratory rate 40 / min
Oxygen saturation 95%
The lungs are clear, but there is inflammation and redness in the throat, and there are swollen lymph nodes in the neck.
According to the NICE traffic light system for assessing fever in children, which of the following is considered ‘amber’?
In your morning clinic, a 13-month-old girl is brought in by her father. She has been unwell for 2 days with a fever that has been over 39ºC. She has a cough and has been refusing to eat. Although she has been drinking normal amounts of milk, her urine output is less than usual. Her nose has been very runny, and she keeps rubbing her left ear. Her father is most worried about her cough and breathing and is wondering if she needs antibiotics.
During the examination, she appears alert but coryzal. Her temperature is 39.2ºC. Her heart rate is 150 beats per minute. Her respiratory rate is 60 breaths per minute. Her capillary refill time is < 2 seconds, and her mucous membranes are moist. You can hear transmitted sounds from her upper airway throughout her chest, but nothing focal. She has no visible rashes. Her throat is red with enlarged tonsils, and her left ear has a red, bulging tympanic membrane. You consult the NICE traffic light system for feverish children. What observation is considered a red symptom, requiring admission to the hospital for further evaluation?
A mother of a 9-month-old seeks guidance. Initially, she opted out of the oral rotavirus vaccine for her child to limit the number of immunisations. However, due to an outbreak at her baby’s daycare, she now desires the vaccine. What should she do?
A 6-year-old boy is brought in by his parents. He has had 3 episodes of acute otitis media in the past year and his teachers have noticed that he seems to be having difficulty hearing. His medical history includes a diagnosis of ADHD. During the examination, you observe a dull left-sided tympanic membrane and diagnose otitis media with effusion. What would be the most suitable course of action?
A 10-year-old boy is presented by his father with a widespread skin rash. The itching started 3 days ago and he has been experiencing fevers. Upon examination, the rash is composed of macules, papules, crusted lesions, and vesicles that are present on most of his body. The father has been administering ibuprofen to alleviate his son’s fever and discomfort.
What is the probable diagnosis and why is ibuprofen not advisable in this case?
Samantha brings her 18-month-old daughter to the clinic for her routine immunisations. The healthcare provider informs her that her daughter will require four different vaccines, including a pneumococcal booster. Samantha inquires about when her daughter received the pneumococcal vaccine previously in the schedule.