PedsCases.com: PedsCases.com: Cases

Cases

1 acclamation 1 comment 1 step 22 responses

By Maury Pinsk. Created on April 1.
An infant with generalized swelling

An 11 month old infant weighing 10 kg presents to the emergency room with generalized edema after development of an upper respiratory tract infection. Blood work shows a serum albumin of 15 g/L, cholesterol of 9.2 mmol/L. What would you expect the lowest urinary protein level to be if you could ...

Topics: renal, pediatrics, nephrology

Case homepage | Acclaim this case

0 acclamations 0 comments 3 steps 13 responses

By Maury Pinsk. Created on April 1.
Potassium conundrum

A 13 year old girl presents to the emergency room with weakness and fainting. Your assessment shows that she is mildly dehydrated, very thin with a weight < 3rd %ile and height is 50th %ile. Initial blood work shows: Na 139 mmol/L (N: 133-145) K 2.9 mmol/L (N: 3.5-4.8) Cl 89 mmol/L (N: 99-105)...

Topics: nephrology, emergency medicine

Case homepage | Acclaim this case

1 acclamation 0 comments 5 steps 15 responses

By Maury Pinsk. Created on April 1.
Pediatric intoxication

A 13 year old girl has a fight with her mom and in protest, drinks about 125 mL of windshield washer fluid. She is in the emergency room, is stable and neurologically appropriate. The following blood work is ordered: Na 135 mmol/L K 4.5 mmol/L Cl 103 mmol/L bicarbonate 21 mmol/L Cr...

Topics: emergency medicine, renal, pediatrics, nephrology

Case homepage | Acclaim this case

0 acclamations 4 comments 9 steps 8 responses

By Peter Gill. Created on June 6.
Sore throat

David, 13-year old male presents to the Emergency Room with his mother complaining of sore throat. He describes a sudden onset of sore throat 2 days ago. He has been feeling more tired then usual and now has trouble eating or drinking due to the pain in his throat. He denies any coughing or ru...

Topics: emergency medicine, infectious disease, general pediatrics

Case homepage | Acclaim this case

0 acclamations 0 comments 5 steps 11 responses

By Peter Gill. Created on June 8.
Painful arm

A mother brings her 4-year old daughter Sarah to the emergency department. She explains that at school the previous day, her daughter was reported to trip over a class-mate and fall. The mother explains that they went to a walk-in clinic last night, x-rays were completed and they were sent home i...

Topics: general pediatrics, emergency medicine, orthopedics

Case homepage | Acclaim this case

0 acclamations 2 comments 16 steps 5 responses

By Juliana. Created on August 7.
The Laughing Baby

You are in the final week of your elective at the Medical Genetics Clinic. Your preceptor is so impressed with your genetics prowess that she sends you to see the next patients alone. You walk into the examining room and introduce yourself to Mrs. Smith, who is a 37 year old accountant from Edmon...

Topics:

Case homepage | Acclaim this case

0 acclamations 4 comments 7 steps 8 responses

By Peter Gill. Created on September 11.
Vomiting in an Infant

You are a third year medical student completing your first rotation in ambulatory clinic in a general pediatrics clinic. Your preceptor sends you in to see a mother with a child complaining of vomiting. A mother has brought in her four-week old baby boy for complaints of vomiting. She explains t...

Topics: general surgery, gastroenterology, general pediatrics

Case homepage | Acclaim this case

0 acclamations 5 comments 5 steps 6 responses

By Peter Gill. Created on September 14.
Hernia rapid fire trivia!

What is the most common type of hernia in children?

Topics: general surgery, general pediatrics

Case homepage | Acclaim this case

0 acclamations 0 comments 4 steps 8 responses

By Lauren Kitney. Created on October 27.
Maintence fluid requirements

You are a third year medical student on pediatrics at the Stollery Children's Hospital in Edmonton. Jessie is a 3 year old 15kg girl who has just had a tonsillectomy. Since Jessie must be NPO after the surgery, your attending asks you to calculate her maintenance fluid requirements and to write...

Topics: endocrinology, general pediatrics, nephrology

Case homepage | Acclaim this case

0 acclamations 2 comments 4 steps 5 responses

By Lauren Kitney. Created on October 27.
Dehydration and fluid managment

John is 3 year old 20 kg child who presents with a 2 day history of diarrhea. Which of the following would you consider when assessing his hydration status? I would like to acknowledge Dr. Couch for this material

Topics: general pediatrics, emergency medicine

Case homepage | Acclaim this case

0 acclamations 3 comments 6 steps 12 responses

By Lauren Kitney. Created on November 6.
Dysmorphic features

You are a third year medical student completing a neonatology elective. One of your patients is a 15 day old infant named Julie who was born at 37 weeks gestational age. Her mother is a 34 year old caucasian woman G1P1 who had an uneventful prenatal history. She is a non-smoker and did not use...

Topics: pediatrics, cardiology, genetics

Case homepage | Acclaim this case

0 acclamations 1 comment 7 steps 8 responses

By Lauren Kitney. Created on November 14.
Abdominal pain, diarrhea & rectal bleeding

Adam, an 8 year old male, is brought to see you by his mother with the complaint of abdominal pain, diarrhea and rectal bleeding. What further information would you like to obtain on history (check all that apply)?

Topics: pediatrics, general pediatrics, gastroenterology

Case homepage | Acclaim this case

0 acclamations 1 comment 8 steps 10 responses

By Peter Gill. Created on January 21.
Fever and Rash

A mother brings in her 14 month old daughter Beth to the clinic because of a "fever and rash." She came in this morning urgently to clinic. Your preceptor asks you go to take the history, examine the patient and report your findings. Upon reviewing the chart briefly prior to entering, you realize...

Topics: general pediatrics, infectious disease

Case homepage | Acclaim this case

0 acclamations 3 comments 9 steps 5 responses

By Peter Gill. Created on January 23.
Copious Secretions in a Newborn

You are a medical student on a NICU elective. You are paged to be present at the delivery of a fetus with polyhydramnios of unknown cause. Which of the following situations are indications for at least 2 people capable of advanced neonatal resuscitation to be present for delivery?

Topics: general surgery, neonatology, gastroenterology

Case homepage | Acclaim this case

0 acclamations 0 comments 10 steps 4 responses

By Peter Gill. Created on February 7.
Acute Joint Pain

Kennedy, a previously well 6-year old boy is brought to your general pediatric clinic with left knee pain. Upon further history taking, you elicit that the pain has lasted for 5 days. Today, Kennedy is unable to bear weight and the left knee is swollen. His mother has given him acetaminophen peri...

Topics: rheumatology, general pediatrics, emergency medicine

Case homepage | Acclaim this case

0 acclamations 0 comments 5 steps 7 responses

By Jonathan Duff. Created on March 8.
Shocking!

A six-year old girl is brought into the pediatric emergency room by her father. She has a had a 3 day history of low grade fever and vomiting. She has had non-billious, non-bloody emesis 3-5x a day for the past 3 days. There is no history of diarrhea, respiratory symptoms or abdominal pain. Sh...

Topics: Critical Care, emergency medicine

Case homepage | Acclaim this case

0 acclamations 1 comment 9 steps 14 responses

By Peter Gill. Created on March 10.
Seizure

You are working an ER shift in your pediatric rotation. A 4 year old male is brought into the Emergency Department being carried by his father. He started seizing approximately 30 minutes ago. You observe and see that the patient is seizing in a generalized tonic-clonic fashion. What is this pr...

Topics: emergency medicine, neurology, Critical Care

Case homepage | Acclaim this case

0 acclamations 0 comments 7 steps 6 responses

By Peter MacPherson. Created on June 15.
Delayed puberty

LEARNING OBJECTIVES After completing this case, the learner should be able to: • Define delayed puberty in a boy • Develop an approach to the history and physical exam in delayed puberty • Know the most common cause of delayed puberty in boys and list other causes of delayed puberty • List basel...

Topics: pediatrics, general pediatrics, endocrinology

Case homepage | Acclaim this case

0 acclamations 1 comment 10 steps 1 responses

By Lauren Kitney. Created on June 25.
Decreased level of consiousness

You are a third year medical student on an emergency medicine rotation. The triage nurse tells you that a young mother has brought in her 2 and 1/2 month old baby boy because he “won’t wake up” and has been “shaking”. You quickly enter the room and find Latisha, a 17 year old first time mom a...

Topics:

Case homepage | Acclaim this case

0 acclamations 1 comment 7 steps 2 responses

By Peter MacPherson. Created on July 8.
Generalized edema

Jeffrey, an 18-month-old child, presents to the emergency department with generalized edema. You walk into the exam room and elicit the following history: Pt ID – Jeffrey, 18-month-old male CC – Generalized swelling HPI - Two days ago, Jeffrey’s father started noticing swelling around his ey...

Topics:

Case homepage | Acclaim this case

0 acclamations 27 comments 10 steps 3 responses

By Chris Gerdung. Created on July 13.
Fever, Cough and Stridor

You are completing an elective in the pediatric emergency department. Allison is a 4 year old girl who presents to you with a 5 day history of high fever, coughing, sneezing, and a runny nose. Her mother had taken her to a Medi-center 2 days ago and was advised that Allison likely had a viral in...

Topics: Critical Care, emergency medicine, general pediatrics, respirology, infectious disease

Case homepage | Acclaim this case

0 acclamations 4 comments 5 steps 2 responses

By Chris Gerdung. Created on July 13.
Trouble Breathing

Craig is a 12 year old boy who presents to you at the Emergency with worsening stridor, light-headedness, urticaria, pruritis and a numb sensation in his mouth. He was brought in by ambulance from a friend’s house after consuming a meal that contained shell-fish. His mother met the ambulance at...

Topics: emergency medicine, general pediatrics, respirology

Case homepage | Acclaim this case

0 acclamations 6 comments 10 steps 1 responses

By Chris Gerdung. Created on July 14.
Fever and Sore Throat

You are completing your Pediatrics rotation and are working in the pediatric emergency department for the night. At 4:00 PM, your preceptor asks you to see Austin, a 3 year old male who has presented with a fever and sore throat. As you enter the room you notice that Austin is awake and alert, ...

Topics: Critical Care, emergency medicine, respirology, general pediatrics

Case homepage | Acclaim this case

0 acclamations 9 comments 12 steps 1 responses

By Chris Gerdung. Created on July 14.
Unwell Child

You are completing an elective at an urban pediatric ambulatory clinic. Your preceptor asks you to see Hanna, a 28 month old female. You introduce yourself to Hanna and her mother, and learn that for the last two days Hanna has been having a runny nose, coughing, and complaining of a sore throa...

Topics: Critical Care, emergency medicine, general pediatrics, respirology, infectious disease

Case homepage | Acclaim this case

0 acclamations 23 comments 11 steps 0 responses

By Chris Gerdung. Created on August 1.
Prolonged Fever

You are doing your pediatrics rotation at a university teaching hospital. Tonight, you are on call with the pediatrics team. You come down to see Owen, an 11-month-old boy who was brought to the emergency department on the advice of his family physician. Owen has a five-day history of fever. Ove...

Topics: rheumatology, general pediatrics, cardiology

Case homepage | Acclaim this case

0 acclamations 0 comments 9 steps 2 responses

By Peter MacPherson. Created on September 2.
Failure to thrive

You are doing your pediatrics rotation at a children’s hospital. You are asked to see a two month old boy (Cody) who has just been admitted for poor weight gain. At two months, he weighs less than his birth weight. The term ‘failure to thrive’ comes to mind, but you are a little foggy as to wha...

Topics: general pediatrics

Case homepage | Acclaim this case

0 acclamations 0 comments 7 steps 1 responses

By Lauren Kitney. Created on September 3.
Human Papillomavirus

You are a third year medical student completing an elective in the child and adolescent protection centre. A three year old male named Johnny is referred to you by his family doctor for a sexual abuse examination. The family doctor was completing a routine physical exam when he discovered peri-...

Topics:

Case homepage | Acclaim this case

0 acclamations 2 comments 11 steps 1 responses

By Lauren Kitney. Created on September 3.
Weight loss in an adolescent

You are a third year medical student completing an urban family medicine rotation. Your first appointment of the afternoon is with a 14 year old girl named Julie. Julie’s mother has made the appointment because she is concerned that Julie has lost a lot of weight over the last few months. Befo...

Topics:

Case homepage | Acclaim this case

0 acclamations 0 comments 9 steps 1 responses

By Lauren Kitney. Created on September 3.
Contraception

You are a general pediatrician in a small community. Today you are seeing Eva, a 16 year old girl whom you have been following for 4 years due to her asthma. Your appointment sheet does not state the reason for her visit today. You enter the exam room and find a tall 16 year old girl reading...

Topics:

Case homepage | Acclaim this case

0 acclamations 2 comments 9 steps 1 responses

By Lauren Kitney. Created on September 3.
Chronic medical conditions in adolescence

You are a third year medical student completing a family medicine elective. You are about to see Jessie, a 15 year old girl who has been followed by your preceptor for 4 years. Jessie was diagnosed with Insulin-dependent Diabetes Mellitus at the age of 12 after presenting to the emergency room ...

Topics:

Case homepage | Acclaim this case

0 acclamations 2 comments 4 steps 4 responses

By Peter Gill. Created on September 9.
4 month old with abdominal pain

A 4 month old girl presents with 2 day history of colicky abdominal pain, vomiting, abdominal distention, bloody stools, and increasing lethargy. General appearance: Alert infant in moderate distress HR: 125, RR: 42, BP: 72/49, Temp: 37C HEENT: Normal, mucous membranes dry Neck: No cervical lymp...

Topics: emergency medicine, gastroenterology, general surgery, Radiology

Case homepage | Acclaim this case

0 acclamations 2 comments 4 steps 3 responses

By Peter Gill. Created on September 9.
18 month old with tender abdomen

18 month old boy presents with a 1 day of intermittent abdominal pain, vomiting, fever and a tender abdomen. He has a past history of duodenal atresia that was surgically corrected soon after birth. What is your differential diagnosis?

Topics: gastroenterology, general surgery, emergency medicine, Radiology

Case homepage | Acclaim this case

0 acclamations 2 comments 4 steps 4 responses

By Peter Gill. Created on September 9.
8 year old with abdominal pain

An 8 year old boy presents to the ER with a 2 day history of abdominal pain and distention. He has a complicated medical history including Schwachman Diamond Syndrome, a bone marrow transplant, and is on immunosuppressants (prednisone, tacrolimus). What is the most concerning finding on this x...

Topics: emergency medicine, general surgery, gastroenterology, Radiology, Critical Care

Case homepage | Acclaim this case

0 acclamations 0 comments 11 steps 4 responses

By Michael J Kapusta. Created on September 9.
Fussy child with fever

A mother brings in her 15 month old son Connor to the emergency department. She says that her son has had a fever for about a week and is concerned because it doesn’t seem to be resolving. What are specific red flags on the history that you want to know about?

Topics: general pediatrics, infectious disease

Case homepage | Acclaim this case

0 acclamations 2 comments 6 steps 4 responses

By Peter Gill. Created on September 15.
Fever and cough in a 22 month old

A 22 month old boy presents with fever and cough for 3 days. Given the history, what are the possible differential diagnoses?

Topics: emergency medicine, general pediatrics, respirology, Radiology

Case homepage | Acclaim this case

0 acclamations 2 comments 6 steps 2 responses

By Peter Gill. Created on September 15.
13 year old with fever, cough, SOB

A previously healthy 13 year old male presents to the ER with fever, cough and shortness of breath. Based on this brief history, what are the possible differential diagnoses?

Topics: emergency medicine, general pediatrics, respirology, Radiology

Case homepage | Acclaim this case

0 acclamations 1 comment 5 steps 4 responses

By Peter Gill. Created on September 15.
Sudden onset cough and respiratory distress

A 14 month old boy presents with the history of sudden onset of cough and respiratory distress. What are your top 3 differential diagnoses?

Topics: emergency medicine, general pediatrics, Radiology, respirology

Case homepage | Acclaim this case

0 acclamations 2 comments 9 steps 4 responses

By Peter MacPherson. Created on September 16.
Neonatal jaundice

As part of your pediatrics rotation, you are working a shift in the Pediatric Emergency room at a university hospital. Concerned parents have brought their newborn boy (Jason) to the emergency department after a home visit from the public health nurse. The nurse felt that Jason was markedly jaund...

Topics: general pediatrics, neonatology

Case homepage | Acclaim this case

0 acclamations 3 comments 5 steps 3 responses

By Peter Gill. Created on September 17.
11 month old with foreign body aspiration

An 11 month old girl has a fever and cough for 6 days. Her clinical status suddently worsens with increased coughing after choking on a carrot. She presents in severe respiratory distress with indrawing, and is very lethargic. Her RR=100, O2 stats = 70% (on room air), HR = 140 Family members ...

Topics: emergency medicine, general pediatrics, Radiology, respirology

Case homepage | Acclaim this case

0 acclamations 1 comment 7 steps 3 responses

By Peter Gill. Created on September 17.
14 yo with chronic cough

A 14 year old boy with a long history of chronic cough and recurrent pneumonias requiring frequent hospitalizations presents to your general pediatrics clinic. Given the history, what are the possible underlying diagnoses?

Topics: emergency medicine, general pediatrics, Radiology, respirology

Case homepage | Acclaim this case

0 acclamations 4 comments 10 steps 3 responses

By Michael J Kapusta. Created on September 21.
Difficulty breathing

A father brings his 4 year old son Adam into the emergency department. Adam is noticeably distressed and has been having difficulty breathing for the last 2 hours. Adam has a history of asthma but his father states that other mild episodes cleared on their own without medication. This time, Adam’...

Topics: emergency medicine, general pediatrics

Case homepage | Acclaim this case

0 acclamations 7 comments 5 steps 7 responses

By Peter Gill. Created on September 21.
7 week old with fever and cough

A 7-week-old female is brought in to the ER with fever, cough, and increasing respiratory distress over 3 days. The baby was born at term with a birth weight of 7 lbs 6 oz. On exam, she had a HR=155, RR 70, O2 sats 90%. Given the above history, what are the possible differential diagnoses?

Topics: general pediatrics, emergency medicine, respirology

Case homepage | Acclaim this case

0 acclamations 0 comments 6 steps 0 responses

By Michelle Bischoff. Created on July 29.
Abdominal Pain in an Adolescent Female

You are completing an elective in Pediatric Emergency when you are asked to see a 14-year-old girl with a two day history of abdominal pain. She also reports a fever of 38°C, nausea beginning eight hours after pain onset, and has not had a bowel movement in four days. Her medical history is unrem...

Topics: emergency medicine, general pediatrics, general surgery, pediatrics,

Case homepage | Acclaim this case

0 acclamations 2 comments 7 steps 1 responses

By Michelle Bischoff. Created on August 12.
Dehydrated Toddler

You are a third year medical student working in Pediatric Emergency when your preceptor sends you to see an 18-month old presenting with vomiting and diarrhea. Mom describes a 2 day history of emesis (normal to bilious) and diarrhea, numerous times daily. She states her son has been taking in ...

Topics: pediatrics, emergency medicine, general pediatrics

Case homepage | Acclaim this case