A 13-year-old girl comes to her GP with concerns about her development. She is the shortest girl in her class and has not yet started menstruating. During the examination, the GP observes that she has low-set ears and cubitus valgus. Based on this presentation, what chest sign is the GP most likely to elicit?
A 5-year-old child is brought to the Emergency Department with a displaced supracondylar fracture. It necessitates manipulation using procedural sedation.
What would be the most appropriate option?
A 6-day-old baby who is 39+6 weeks’ gestation on the Neonatal Unit develops jaundice with a conjugated fraction of 42% (reference < 20%). The baby has feeding difficulty and so is being fed through a nasogastric tube. Investigations are being completed into a diagnosis of conjugated hyperbilirubinaemia. The baby is currently under single phototherapy for his jaundice.
What is the most suitable course of treatment?
A mother arrives with her 3-year-old son who was diagnosed with cow’s milk protein allergy (CMPA) at 6 months old. He has been on a dairy-free diet and fed hydrolysed milk until he turned 1. Recently, he successfully completed the milk ladder and has been drinking raw milk for the past month without any reactions or diarrhoea. The mother is curious if this is typical or if her son was misdiagnosed earlier. IgE testing was conducted and came back normal. What advice would you give to the mother regarding her son’s situation?
A 14-year-old girl visits the doctor with her father. She has been skipping dance practice for the past few weeks and avoiding social events. This is unusual for her, as she was previously very active in her dance group and enjoyed spending time with her friends.
What is the recommended treatment for social anxiety in adolescents?
A 9-year-old boy has been experiencing progressive gait disturbance and falls. He was initially evaluated by a paediatric neurologist at the age of 5 years due to unsteady gait and toe walking. His gait unsteadiness began around the age of 4 years with frequent falls, and he had also developed hand tremors prior to this visit. Upon further examination, he was found to have pes cavus, mild scoliosis, and no cardiac murmur. What is the mode of inheritance for the underlying condition?
A 16-year-old girl with short stature visits her GP due to delayed onset of menstruation. During the physical examination, the GP observes a broad neck and detects a systolic murmur in the chest. What condition is most likely causing these symptoms, and with which of the following options is it associated?
During a routine examination of a 4 day old baby born at 36 weeks gestation, a very prominent murmur is heard during systole and diastole, with the loudest point being over the left sternal edge. A chest X-Ray reveals massive cardiomegaly, particularly in the right atrium. The mother of the child has bipolar disorder but is otherwise healthy and has no congenital heart problems. There is no significant family history except for a paternal cousin who developed cardiomyopathy in their early twenties. Based on the given information, what is the most probable underlying diagnosis?
A three-year-old male is brought into the paediatric emergency department by his mother. He has been coughing for four days, producing green sputum and has been off his food. He has been drinking water but has only wet two nappies today. On examination, he has a moderate intercostal recession, right-sided lung crackles and appears withdrawn. His mucous membranes appear dry.
Based on the NICE traffic light system, which symptom of the child is the most worrying?
A 28-year-old primiparous woman delivers her first child via caesarean section at 38 weeks. Both the mother and baby are in good health after delivery, and there are no complications during the postoperative period. As part of the routine post-birth checks, a sample of umbilical cord blood is collected and analysed, revealing a glucose level of 2.4 mmol/L. What is the appropriate course of action?