A 27-year-old man attends clinic rather worried because he has heard that one of his friends has got mumps.
He says that he did not have mumps as a child and doesn’t think he has had any immunisations against it. He has heard that adult men can become infertile following mumps and wants to know if he is at risk of this if he gets mumps.
What percentage of post-pubertal males who contract mumps will develop orchitis as a complication?
A 4-week-old girl is referred to you by the health visitor after her mother noticed that she ‘looked yellow’. On examination, she is jaundiced, with dark urine and pale stools. Examination is otherwise normal. The mother had an uneventful pregnancy and birth, and the baby has had vitamin K.
What is the most likely diagnosis?
A 5-year-old girl presents with a three-day history of ‘puffiness’ around her eyes. She seems well in herself and her mother is concerned that she may have hay fever. On examination, she has some pitting oedema around her ankles where her socks have been, but is otherwise well. Dipstick testing of her urine reveals protein 4+ and blood 1+.
What is the most likely diagnosis?
A 4-year-old boy has been unwell, looks pale, is anorexic and has lost weight. He has abdominal pain and a pain in his leg and a limp. You are concerned about his appearance and worry he may have a malignancy.
Which is the feature that will MOST LIKELY be present if he has a neuroblastoma?
Your health visitor wants to put up a sign in the child health clinic drawing attention to vitamin D supplementation for infants, and she wants to check the recommendation with you.
Advice from PHE is that infants under the age of one should consider taking a daily supplement containing how much vitamin D, during autumn and winter?
A father asks for some advice regarding the hearing test result of his 6-month-old baby. He tells you that he was told that the baby’s hearing was ‘not clear’ in both ears when it was tested at the pediatrician’s office. He says that the hearing test was repeated at the office and the repeat test gave the same result.
You check the clinical record and the screening result sent to the office confirms ‘not clear’ responses in both ears on both screening tests. He says that he was given some information at the time about the result of the hearing test but cannot remember what was said and cannot find the leaflet he was given.
Which of the following should you advise?
You are asked to see a 3-day-old newborn baby who was born by normal vaginal delivery without any complications. The parents report that the baby has suddenly become ill and deteriorated over the last few hours. The child is drowsy and lethargic, has a bulging fontanelle, and a high fever. You suspect meningitis and call for immediate transfer to the hospital.
What is the most probable causative agent for this condition?
You are reviewing a 16-year-old girl with a diagnosis of mild depression. She has no past or current history of self harm or suicidal thoughts. She was initially seen six weeks ago and is being reviewed today for the second time over this period.
You discuss her symptoms and things are unchanged from when she was last seen four weeks ago with persistence of the mild depression. She tells you that she cannot see herself improving and is keen to engage with any help that may be appropriate.
What is the most appropriate approach in this instance?
You see a 3-year-old girl who you suspect has asthma. She has a moderate response to an inhaled short-acting beta-2-agonist (SABA) but you are planning to trial an inhaled corticosteroid to see if her control can be improved.
How long should a trial of inhaled corticosteroid be for a child under three years of age with suspected asthma?
You see a 7-year-old boy with his mother. He has had a productive cough for 2 weeks. His vital signs are within normal range for his age. On examination, there are no signs of respiratory distress, but you hear crackles in the left base.
He is normally fit and well. He is not on any regular medications. He has no known drug allergies.
What is the most suitable course of action to take next in managing this patient?