A 5-year-old girl is brought to the Emergency Department with a 6-day history of fever and irritability, with red eyes and reduced eating for the last 24 hours. On examination, she was noted to have dry and cracked lips, mild conjunctivitis and cervical lymphadenopathy.
Given the likely diagnosis, what is the most important investigation?
A 10-week-old girl is brought to the emergency department with concerns about her breathing. Three days ago, the girl started with a runny nose and mild fever. She seemed to be getting better for a day, but now she is coughing frequently, struggling to breathe, and refusing to eat.
During the examination, there is evidence of nasal flaring. On chest auscultation, there are bilateral crackles and an expiratory wheeze. Her temperature is 38.1ºC (normal: 36.1-38.0ºC), oxygen saturations are 97% on air (normal: >96%), the heart rate is 128 beats per minute (normal: 115-160), and she has a respiratory rate of 50 breaths per minute (normal: 25-45).
What is the most appropriate treatment for the likely diagnosis?
You are seeing a 6-year-old boy that has been brought in by his mother with a sudden onset of fever and a sore throat this morning. His mother informs you that he is prone to tonsillitis and would like some antibiotics as they had worked well previously.
On examination he is alert, sitting upright and unaided with a slight forward lean. He has a temperature of 38.5 ºC, heart rate of 130/min, respiratory rate is normal. There is no cyanosis or use of accessory muscles, but you do note a mild inspiratory fine-pitched stridor.
What would be the most appropriate next course of action?
In a toddler, what symptoms are unlikely to be present in cases of cardiac failure?
A 7-year-old boy visits his pediatrician complaining of a dry cough that has been bothering him for the past three days. The child has been experiencing intense coughing spells that make him turn blue and vomit. He had previously suffered from a cold with fever, sore throat, and a runny nose. The doctor diagnoses him with pertussis and prescribes a course of clarithromycin.
What guidance should be provided regarding the child’s return to school?
A 2-month-old baby, born at 38 weeks, is brought in due to increasing fussiness around 30-60 minutes after feeds, frequent regurgitation, ‘colic’ episodes, and non-bloody diarrhea. The baby has not experienced fever, urticaria, angioedema, or wheezing. The baby is exclusively formula-fed and has mild eczema in the flexural areas. The baby’s weight remains stable between the 50-75th centile. What is the most appropriate next step in managing this baby’s symptoms?
A 16-year-old girl is brought to the Emergency Department after overdosing on alcohol and paracetamol. She was discovered by her friend, unconscious in a local park, after sending a concerning text message. Her parents were both at work at the time. Upon regaining consciousness, she expresses embarrassment and explains that she had an argument with her boyfriend, now regrets her actions, and wishes to return home. All of her blood tests come back normal and she is deemed medically stable.
What is the best course of immediate action for her management?
You are a Foundation Year 2 (FY2) doctor in the Emergency Department. You are asked to see a 7-year-old girl. She has been brought in by her grandmother with a wrist injury following a fall from a swing while staying with her mother. Her grandmother reports that this is the third time in the past four months that she has been injured while staying with her mother. On examination, she has several bruises on her arms and legs. You are concerned about the welfare of the child.
What is the most appropriate immediate action for you to take?
A 16-year-old boy visits his school counselor with his older brother. He reveals that his stepfather has been physically abusing him for the past year.
What is the most suitable course of action?
What is the preferred investigation for diagnosing vesicoureteric reflux in pediatric patients?