You are asked to help with the resuscitation of a premature neonate who is displaying respiratory distress immediately after birth at 36 +4 weeks. During auscultation of the precordium, you observe the absence of heart sounds on the left side but can hear tinkling sounds. Additionally, the infant is exhibiting cyanosis.
What is the most appropriate initial course of action?
A 4-month-old infant presents with feeding difficulties, failure to thrive, and episodes of bluish pale skin during crying or feeding. On examination, a harsh systolic ejection murmur is heard over the pulmonic area and left sternal border. A chest radiograph during birth was normal. A second radiograph at presentation shows a boot-shaped heart.
What is the most likely embryological mechanism responsible for the development of this condition?
You are scheduled to see a 12-year-old girl in your clinic. The booking notes indicate that her mother is worried about her daughter’s growth compared to her peers. Before the appointment, you quickly review the patient’s medical records. The patient’s past medical history includes asthma, attention deficit hyperactivity disorder, and being born prematurely at 35 weeks. The patient is taking methylphenidate, a beclomethasone inhaler during the winter months, and a salbutamol inhaler. The patient’s family history shows that both parents are of average height, and a blood test conducted a year ago revealed borderline low ferritin levels. What is the most relevant information for this presentation?
A 4-year-old child has been referred by their GP due to chronic constipation that is not responding to treatment. What specific details in the child’s medical history could suggest a possible diagnosis of Hirschsprung’s disease?
A 5-year-old girl, who has been wetting the bed at night attends surgery today with her grandfather, as her mother is at work. Her grandfather is worried because it was also an issue for her older sister, who is 10-years-old and she is prescribed desmopressin. The girl in front of you is otherwise well and her bowels open regularly. An examination is unremarkable and she has a soft non-tender abdomen.
What recommendations would you make?
A 32-year-old woman gives birth to a 37-week gestational age male neonate. Within 6 hours after delivery, the neonate shows signs of excessive respiratory efforts and tachypnoea. There is grunting and intercostal retraction. A chest X-ray reveals bilateral pulmonary oedema with a ground-glass appearance. What antenatal examination findings are most likely to have been observed in the mother?
You are assessing a 9-month-old infant with suspected bronchiolitis. What sign or symptom should raise concern for a possible hospital referral?
You are working in the Neonatal Intensive Care Unit and currently assessing a 3-day-old boy with respiratory distress due to meconium aspiration. The mother is visibly upset and asks if there was anything she could have done to prevent this.
After reviewing the medical history, you find that the baby was conceived through in vitro fertilization, there were no complications during the pregnancy, but he was delivered via C-section at 41 weeks with a birth weight of 2.6kg.
What is the most significant risk factor for meconium aspiration in this particular case?
Which one of the following is not a risk factor for developmental dysplasia of the hip?
A two-hour-old baby born at 38+5 weeks in the Special Care Baby Unit is exhibiting mild respiratory distress, with subcostal recessions and grunting. The baby’s respiratory rate is 68/min without any apnoeas, their heart rate is 150 bpm, and their axillary temperature is 36.8ºC. The baby appears pink, with normal pre-post ductal saturations and no additional heart sounds. Fontanelles are normal, and their birth weight is within the normal range.
The chest X-ray shows hyperinflation and a thin fluid line in the right horizontal fissure. What is the most significant risk factor for the likely diagnosis?