A 25-year-old man with cystic fibrosis is scheduled for a follow-up appointment with his respiratory specialist. He has been experiencing more frequent respiratory infections and is seeking advice on how to minimize his risk of contracting further infections.
What is the most suitable answer?
A 5-year-old girl is discovered unresponsive and not breathing. There are no apparent obstructions in her airway. A paramedic administers 5 rescue breaths using a bag-valve-mask connected to 100% oxygen. She has a heart rate of 30 beats per minute and is cold to the touch in her extremities. Despite the rescue breaths, she is not making any effort to breathe on her own.
What is the best course of action in this situation?
A 5-year-old girl presents with a 3-day history of passing loose stools and non-bilious vomiting. She has passed 6 loose stools and vomited 3 times over the last 72 hours. No visible mucous or blood seen in the stool, and urine output has not changed according to her mother. She is able to tolerate oral fluid and liquid food.
She has not travelled abroad recently and there are no sick contacts. Her vaccination schedule is up-to-date and there are no concerns regarding her growth and development.
On examination, she appears well and is alert and responsive. She has warm extremities and capillary refill time is <2 seconds. Her vital signs are normal. Peripheral pulses are strong and regular. There is normal skin turgor and there are no sunken eyes. What is the appropriate management for this patient?
A 3-year-old child has a 24-hour history of being generally unwell with a barking cough. Their parent says they make a loud noise when they breathe in and their symptoms are worse at night. They have a temperature of 38.5 °C.
What is the most probable diagnosis?
A premature neonate is delivered via category II emergency caesarean section at 34+3 weeks for fetal distress. The obstetrician notes the baby is delivered with the cord wrapped around its neck and appears floppy and ‘blue’. The neonatal team immediately begins resuscitation as the initial APGAR score is 3. At 10 minutes, the score is 5 due to cyanosis, heart rate of 120 bpm, minimal response to stimulation, poor tone, slow and irregular respiratory effort with a respiratory rate of 12/min. What is the most appropriate management of this premature neonate to reduce hypoxic ischemic encephalopathy (HIE)?
Sophie is a 6-year-old girl who requires a blood transfusion after a serious accident. Her condition is critical and she needs urgent resuscitation. Sophie has suffered significant blood loss and will not survive without a transfusion. However, her parents are Jehovah’s Witnesses and are present, but they refuse to provide consent for the blood transfusion. What is the most appropriate course of action?
A 5-year-old girl comes to the GP with a sudden onset of limp. She appears to be in good health. During the examination, she displays an antalgic gait. An MRI scan reveals decreased blood flow to the left hip, leading the doctor to suspect Perthes’ disease. What is the most suitable course of action?
A 6-year-old girl walks with a limp due to right hip pain, which is relieved by rest and made worse by walking or standing. Her vital signs are normal. The Trendelenburg sign presents when she stands on her right leg.
X-rays reveal periarticular right hip swelling in soft tissue. A bone scan reveals reduced activity in the anterolateral right capital femoral epiphysis.
What is the most likely diagnosis?
A 10-year-old boy comes to the GP with his father, complaining of right-sided hip pain that has been present for the past 3 weeks. The pain has gradually worsened over time. When asked to point to the location of the pain, he indicates his right hip and groin area. Upon examination, his heart rate is 71 bpm and temperature is 37.3ºC. He is able to walk, but with moderate discomfort and an antalgic gait that causes him to out-toe. Passive movement of the hip reveals a loss of internal rotation of the right leg in flexion. What is the most likely diagnosis?
A 4-year-old girl is brought to the emergency department by her father due to pain in her left hip. She has been complaining of pain and is hesitant to put weight on her left leg. She has a normal range of movement in both legs. Her father reports that she has been feeling sick with cold symptoms for the past few days and she currently has a temperature of 37.8 ºC.
What is the probable diagnosis?