A 10-day old infant is brought to the emergency department by his mother due to poor feeding and drinking for the past 48 hours. The mother is concerned about the baby’s weight gain and has noticed pale stools. During the examination, the baby appears jaundiced and has an enlarged liver. The medical team performs a newborn jaundice screen and considers biliary atresia as a possible diagnosis. What clinical finding would be most indicative of biliary atresia?
A 2-year-old child is brought to the emergency department by his parents. The parents have noticed that he is clutching his stomach. He has not eaten or drank any fluids for the entire day and he has vomited twice. His mother states the vomit was green in colour.
The doctor suspects a diagnosis of intestinal malrotation due to the child’s symptoms and orders an abdominal ultrasound. The ultrasound shows a whirlpool sign, confirming the diagnosis. On examination, the child appears distressed and has a distended abdomen with absent bowel sounds. He looks unwell.
What is the appropriate management for this patient?
A 4-week-old girl presents with vomiting, jaundice and dehydration. Investigations reveal hypokalaemia and metabolic alkalosis.
What is the most appropriate initial management?
A 5-year-old girl is brought to the Emergency Department by her father who is concerned about her recent limp. She had a cold recently, but is otherwise healthy and has not experienced any injuries. The child has met all developmental milestones and there were no complications during pregnancy or birth. What is the probable reason for her current condition?
A 6-year-old girl is brought to the Emergency Department by her parents. She has been experiencing pain in her left hip for the past two weeks and has been limping. Upon examination, there is a slight decrease in the range of motion in her left hip joint, but no signs of swelling or effusion. Her right hip appears normal. Blood tests, including cultures, are negative. What is the most suitable initial management option for the underlying diagnosis?
A 29-year-old primiparous woman who is 20 weeks pregnant comes in for a consultation after her foetal anomaly scan revealed polyhydramnios and a midline sac containing bowel. She has no significant medical history and is not taking any regular medications. She had planned for a home birth and is now concerned about how this condition will affect her delivery.
What is the best course of action for managing this condition?
A 7-year-old boy comes to the doctor’s office with his mother, reporting pain in his left hip. The mother mentions that he had a recent bout of the flu. Upon examination, the boy appears alert with a heart rate of 80 bpm, respiratory rate of 20 breaths/min, temperature of 38.5ºC, blood pressure of 120/80 mmHg, and oxygen saturations of 98% on room air. What is the best course of action for management?
A 4-year-old girl with cerebral palsy comes to the GP with her father for a check-up. Upon examination, she has a delay in her overall development. She is not yet able to walk or crawl, but she can use her fingers to pick up objects and is happily playing with toys during the visit. She can say a few words, such as mom and dad. During the examination, you notice some bruises on her abdomen, left elbow, and right forearm. Her father explains that these bruises are due to her clumsiness and he is concerned that she will continue to hurt herself. He mentions that her mother had a similar condition that required oral steroids and wonders if his daughter has developed the same condition.
What is the next step in managing this patient?
A 12-hour-old neonate is evaluated in the neonatal unit after a normal vaginal delivery at 35 weeks’ gestation. The mother reports no issues thus far. During the examination, a continuous ‘machinery-like’ murmur is heard, and a left subclavicular thrill is observed. The neonate has a large-volume collapsing pulse. An echocardiogram is performed, revealing the suspected defect but no other anomalies. What is the most suitable course of action at this point?
A 10-year-old boy with severe haemophilia A is brought to the Emergency Department by his mother due to a nosebleed that has been ongoing for over 30 minutes. He is currently receiving regular injections to manage his condition but is aware that further treatment may be necessary in the event of a significant bleed. What is the most appropriate course of action for managing this patient?