A mother brings her 8-week-old baby to the GP clinic for their routine 7-week check-up. The baby appears happy and responsive during the assessment. During the examination, you observe weak femoral pulses on both sides. The rest of the examination is normal.
What is the most suitable course of action to take?
A 16-year-old known type 1 diabetic presents with vomiting, abdominal pain, and drowsiness. During the examination, you detect a distinct smell of pear drops on her breath. Despite the severity of her condition, she insists on leaving to attend a friend’s birthday party. After discussing the potential consequences of leaving, she appears to comprehend the risks and can articulate her decision. However, her parents believe she should remain for treatment. What course of action should you take?
You are conducting a routine check-up on a one-month-old infant and notice that the baby has ambiguous genitalia. The parents are understandably upset and want to know what could have caused this. What is the most probable reason for the ambiguous genitalia in this situation?
A 4-year-old girl is brought to her pediatrician as her mother has noticed her limping for the past day. She is up to date with her vaccinations and has no past medical history, although she did have symptoms of a cold a few days ago.
During the examination, the girl appears to be in good health. Her temperature is 38.3ºC, her heart rate is 110 beats per minute, her respiratory rate is 25 breaths per minute, and her oxygen saturation is 100% on air. There is no redness, swelling, or erythema to her hip joint, and she allows slight movement of the hip, although she becomes upset with excessive movement.
What is the most appropriate course of action?
A 6-year-old boy fell off his bike and now has an angled left elbow. His left hand feels cold and there are no detectable brachial, radial, or ulnar pulses. An X-ray of the elbow reveals a displaced humeral supracondylar fracture on the left side (Milch Type 1/Gartland II). What is the most suitable initial course of action?
A 6-year-old child complains of difficulty in hearing. He has had several fractures following minor falls. On examination, his legs appear short and deformed, and his sclera appear blue.
What is the most likely diagnosis?
A 16-year-old girl visits your GP practice seeking contraception. After counseling her, you both agree that the implant would be the most suitable option. You believe that she has the ability to make this decision and give her consent for the insertion. However, during previous consultations, you have found her to lack capacity for certain decisions and have involved her parents. According to the GMC, what is necessary to proceed with the implant insertion?
A 10-year-old girl visits her GP complaining of stiffness, swelling, and pain in both knees. During the examination, the doctor observes a salmon-pink rash on her legs. What is the probable diagnosis?
An 18-year-old girl visits her GP with worries about not having started her menstrual cycle yet. Apart from that, she feels healthy. During the examination, she appears to be of average height and has developed breasts, but has minimal pubic hair growth. The doctor can feel two lumps in her groin area upon examination of her abdomen. Her external genitalia seem normal. What is the probable diagnosis?
A 5-year-old patient is referred to the Paediatric Unit after having presented to her General Practitioner (GP) twice over the course of the week with fever and a red tongue and throat. A course of penicillin V has so far been ineffective. She is fully immunised and has not been in contact with any other children with notifiable infectious diseases. Her parents report that she has not been well for around 7 days with a high fever, which they have been unable to bring down with paracetamol and ibuprofen. She has had a cough with coryzal symptoms and has now developed conjunctivitis.
On examination, she looks unwell. Temperature is 38 °C, heart rate 124 bpm and respiratory rate 28. Capillary refill time is 2 s centrally. She has bilateral conjunctivitis. She has a red oropharynx and a red tongue. There is cervical lymphadenopathy and a widespread maculopapular rash. Her hands and feet are red and there is some peeling of the skin around the toes.
Which of the following diagnoses should be made?