A 3-month-old previously healthy boy is brought into the pediatrician’s office by his father who is concerned about a change in his behavior. The father suspects his child has a fever. During the examination, the baby is found to have a temperature of 38.5 ºC but no other notable findings.
What should be the next course of action?
A 9-week-old boy is presented to his GP by his parents who are concerned about an undescended testis. The patient was born at term following an uncomplicated pregnancy and birth and has been healthy since birth. On examination, the left testicle is not palpable in the scrotal sac and is unretractable, while the right testicle has fully descended. What is the most suitable next step in managing this patient?
A 6-month-old boy is brought to the Urgent Paediatric Clinic with a urinary tract infection (UTI) that was treated in the community. He was born at term and has been healthy throughout infancy, without previous history of UTI. There is no significant family history. The child’s development is appropriate for his age and there have been no concerns about his growth. The antibiotics took effect after 4 days and he is currently doing well. Physical examination, including vital signs, is unremarkable. The child’s height and weight are both at the 50th percentile. The microbiology results confirm a UTI caused by Enterococcus. What is the most suitable imaging approach that should have been taken/ordered?
A 14-year-old boy comes to the clinic with complaints of central abdominal pain and haematuria that have been present for a week. He also reports experiencing pain in both knees. Upon examination, a non-blanching purpuric rash is observed on his legs and buttocks. Urine dipstick results show blood ++ and protein +. Additionally, his renal function is abnormal with urea levels at 26.3 mmol/l and creatinine levels at 289 μmol/l. What is the most probable diagnosis?
A 10-year-old girl presents to the Emergency Department with her mother, complaining of right iliac fossa pain for the past 2 days. She has no significant medical history, except for a recent cold and sore throat. She has had a high fever for the past 2 days and has lost her appetite, but denies any other symptoms. On examination, her temperature is 38.9 °C and her heart rate is 130 bpm. She has palpable and slightly tender submandibular and cervical lymph nodes on both sides. Her chest is clear, with transmitted sounds from the upper airways. Abdominal examination reveals marked tenderness in the right iliac fossa without guarding. A urine dipstick shows 2+ ketones and 1+ protein. Her FBC results are as follows: haemoglobin 145 g/l (normal range 135–175 g/l), WCC 14.3 × 109/l (normal range 4–11 × 109/l), and platelets 425 × 109/l (normal range 150–400 × 109/l). What is the most likely clinical diagnosis?
A 3-month-old boy is presented to surgery with vomiting and poor feeding. The mother reports a strong odor in his urine, indicating a possible urinary tract infection. What is the best course of action for management?
A 10-year-old boy is brought to surgery during an asthma attack. According to the British Thoracic Society guidelines, what finding would classify the asthma attack as life-threatening instead of just severe?
A 10-year-old girl is brought to the attention of a psychiatrist by her father with complaints of difficulty concentrating at home and at school. She is reported by the teachers to be easily distracted which is adversely affecting her learning. She also shows repeated outbursts of anger and her father thinks she has ‘too much energy’. The psychiatrist diagnoses her with attention-deficit hyperactivity disorder (ADHD) and starts her on methylphenidate (Ritalin).
What parameter must be monitored every 6 months in this patient?
A 7-year-old boy is brought in by his father for symptoms of upper respiratory tract infection. During examination, you observe multiple bruises on his arms with a circular pattern. Which type of bruising is more frequently associated with physical abuse in children?
A 3-week-old baby girl is brought to the emergency department due to continuous vomiting. According to the mother, the baby’s vomiting is like a fountain. What is the most suitable investigation to confirm the suspected diagnosis?