A 4-week old infant comes in with excessive vomiting and constipation. The mother reports that the baby has vomited several times, but has been content during feedings. The baby appears visibly dehydrated and a small lump is detected in the abdominal area during examination. What arterial blood gas results would you anticipate?
A 6-hour-old baby girl is assessed after being born at 37 weeks without any complications. The mother has not reported any issues and breastfeeding has been going smoothly. During the examination, the neonate appears to be in good condition. However, a blood glucose test reveals a reading of 2.0 mmol/L. What is the best course of action at this point?
The pediatrician is asked to review a 4 hour old term baby by the nurse. The mother had no antenatal concerns and was not on any medication during pregnancy. The baby has not yet latched to the breast and appears lethargic. A heel prick blood sugar test was done and the result was as follows:
Glucose 2.5 mmol/L (4.0-5.9)
Upon examination, the baby was easily rousable and had a good suck. He had normal tone and cardiovascular examination was unremarkable. However, he had not passed urine or opened his bowels yet.
What should be the first step in the pediatrician’s management plan for this baby?
A 5-year-old boy is brought to the emergency department with a fever, sore throat, and difficulty swallowing that started yesterday and has gotten worse. During the examination, he appears anxious and leans forward with his hands on his knees, drooling. His temperature is 38ºC, oxygen saturation is 96% on air, heart rate is 100 beats per minute, respiratory rate is 24 breaths per minute, and blood pressure is 100/60 mmHg.
Despite receiving intravenous dexamethasone and inhaled budesonide, the child’s condition continues to deteriorate. He now has audible stridor, and the on-call anaesthetist is paged. What intervention should be considered next?
A 6-year-old girl has been referred to the enuresis clinic by her pediatrician due to ongoing bedwetting. Her mother has expressed concern as the girl has never had a dry night. The pediatrician has provided advice on diet, fluid intake, and toileting habits, but the bedwetting persists despite the use of a reward system. The mother has contacted the enuresis clinic for further intervention. What is the likely intervention that will be provided?
A 15-year-old boy comes to the emergency department complaining of groin pain that has been present for the past two hours. He reports feeling nauseous and has vomited twice. He admits to having unprotected sexual intercourse recently. Upon examination, there is swelling and tenderness in the left testicle and scrotum. The left side lacks the cremaster reflex, and lifting the affected testicle causes more pain. What is the probable diagnosis?
A 15-year-old boy presents to the Emergency Department at night with a sudden onset of severe pain in his left testicle that started four hours ago. Upon examination, his left testis is visibly swollen and extremely tender to touch. What is the probable diagnosis?
A 5-year-old girl is brought in by ambulance. Her parents explain that she has had cold symptoms for the last 24 hours but is generally well. They describe her walking towards them in the park when she suddenly went floppy and all four limbs started shaking. This lasted for around 1 minute, during which time she did not respond to her name and her eyes were rolled back. She remained drowsy for the next 30 minutes or so in the ambulance but is now well, alert and active, moving all limbs normally.
What is the most likely diagnosis?
A 4-year-old boy is admitted to hospital. He was diagnosed with Down syndrome soon after birth. He has not opened his bowels for the past few days and complains of abdominal pain. His abdomen is distended, and he has had several episodes of vomiting. The mother denies any complication during pregnancy. An abdominal X-ray does not show any double bubble sign but rather shows a picture of bowel obstruction.
Which of the following investigations would provide a definitive diagnosis?
A 6-year-old girl comes to the GP with a pink spotted rash on her torso that has spread to all her limbs. Her mother reports that she had a high fever for three days before the rash appeared, and that she seemed to be improving before that. The girl is now without a fever.
During the examination, the GP observes a maculopapular red rash on the girl’s trunk and limbs. All other aspects of the examination are normal, and her vital signs are stable.
What is the probable diagnosis?