A 6-month-old girl is brought to clinic by her father, who complains she is ‘having difficulty breathing’. A harsh inspiratory stridor is heard. You suspect that she may have tracheomalacia.
Which of the following would support this diagnosis?
An anxious mother has called the clinic because she suspects that her unimmunised 4-year-old has measles. The child has been feeling unwell for a few days and has now developed a red rash. The mother is worried about the likelihood of measles. Typically, where does the rash begin with measles?
A 6-month-old child is diagnosed with napkin/nappy rash.
Which of the following is the most appropriate treatment of mild napkin rash?
A 10-year-old boy wakes up screaming at night.
This usually happens shortly after he has gone to sleep. His parents say that he sits up and seems awake but doesn’t respond to them. Episodes last a few minutes and then the child nods off again. His parents have taken his pulse during the episode and say it is very fast. When woken after a recent attack, he appeared confused about what had happened.
This occurred about four months ago and happened most nights for about two weeks and then went away on its own.
Which one of the following is the diagnosis?
A 7-year-old boy complains of abdominal pain that has been causing him to miss school for the past two months. What factor suggests an organic cause rather than a functional one?
In your clinic you see a 6-year-old child who has arrived in the United Kingdom from India with bowed legs, muscle spasms and a pigeon chest.
What is the most probable diagnosis?
A 4-year-old girl of South Asian origin presents with bowed legs, thickened ankles and wrists and a prominent forehead. Prior to this, she had not attended the surgery much and her mother is of the opinion that her development has been normal.
What is the most likely cause of these features?
A 6-year-old boy is brought to the General Practitioner by his mother. She reports that 1-2 hours after he has gone to sleep, she frequently finds him sat up in bed screaming and with his eyes open. He doesn’t seem to recognise her, is confused and unable to communicate. After about five minutes he settles down to sleep. He is unable to remember anything about this the next day. On the day after it has happened he is more tired than usual.
Which of the following is the most likely diagnosis?
A 7-year-old boy has developed involuntary movements of his arms and face over the last few days. Some of these he converts into apparently purposeful movement by pushing back his hair or scratching his nose. There is reduced tone in the limbs, and he is unsteady. He seems unconcerned and intermittently giggles. His mother tells you that he had a sore throat four weeks previously.
What is the most likely diagnosis?
A patient expresses concern about a neighbouring family (who are also patients of yours) in which she believes a teenager is at risk of maltreatment.
Which of the following is associated with the greatest risk of teenage maltreatment?