As a foundation doctor on the neonatal ward, you consult with your supervisor regarding a patient who is five days old and displaying symptoms of cyanosis, tachypnoea, and weak peripheral pulses. Your suspicion is that the patient has a duct dependent cardiac lesion. Once this is confirmed, what would be the most suitable course of treatment?
What is the initial indication of puberty in young girls?
A mother brings her 5-year-old son to the clinic as she is worried about his bedwetting habit. Unlike his older sibling who stopped bedwetting at the age of 4, this child still wets the bed at night. The mother is seeking advice on possible treatment options. What is the best course of action to manage this issue?
At what age do most children attain urinary incontinence during the day and at night?
A 7-year-old girl presents to her General Practitioner with worsening pain in her right ear. She presented four days ago and was diagnosed with otitis media; she was then discharged with return advice. On examination, she is febrile. She has a normal ear canal and a bulging, red tympanic membrane. Behind the right pinna, there is an area of redness and swelling.
What is the most appropriate management option for this patient?
A 9-month-old girl is presented to the clinic. About 5 days ago, she became feverish after being fussy the day before. The fever subsided after approximately 3 days, but she developed a rash afterwards, which prompted her mother to bring her to the clinic. She is consuming about 80% of her usual feeds, has wet nappies, and has had three instances of loose stools. On examination, she is alert, has a temperature of 37.2ºC, and has clear lungs and unremarkable ears/throat. There are several blanching, rose pink macules on her trunk. What is the most probable diagnosis?
A 9-year-old boy with asthma is brought into the GP surgery with a cough and shortness of breath. Examination reveals a respiratory rate of 34 breaths/min, apyrexial, wheeze throughout his chest and a peak expiratory flow rate (PEFR) of half his predicted value.
Which of the following treatments is the best option?
You are seeing a 5-year-old boy in your clinic who has a history of multiple wheezy episodes over the past 4 years and was diagnosed with asthma. He was admitted to the hospital 5 months ago with shortness-of-breath and wheeze and was diagnosed with a viral exacerbation of asthma. The paediatric team prescribed him a Clenil (beclometasone dipropionate) inhaler 50mcg bd and salbutamol 100mcg prn via a spacer before his discharge. His mother reports that he has a persistent night-time cough and is regularly using his salbutamol inhaler. On clinical examination, his chest appears normal. What would be the most appropriate next step in managing this patient?
A 10-year-old boy is being seen in the paediatric asthma clinic for a review of his asthma. He was diagnosed with asthma 6 months ago and has been using a salbutamol 100mcg metered dose inhaler with a spacer. According to his mother, he has been using his inhaler about 4 times a week and has had 1 episode of waking up at night with difficulty breathing. There have been no recent respiratory infections or changes in his environment. On examination, he appears to be in good health. His inhaler technique is satisfactory. Do you recommend any changes to his asthma medication?
A 6-month-old is brought in by a concerned mother. She reports her baby crying after feeds and drawing his legs to his chest for several weeks. His growth is good and examination unremarkable.
Which of the following is the best treatment option?