Left-Sided Appendicitis in an 11-Year-Old Girl
January 1st 2008An 11-year-old girl was brought to the emergency department (ED) after 3 days of intermittent, dull, nonradiating left lower abdominal pain. She also had 3 episodes of nonbloody, nonbilious emesis in the 2 days before presentation. Three days earlier, the patient had been vaccinated against influenza and varicella by her pediatrician.
Cystic Fibrosis: Classic Radiographic Findings
January 1st 20081. The chest radiographs (Figure 1) of a 9-year-old child reflect the classic findings of a particular disease. Among other findings, the size of the patient's heart is_____? A. Enlarged. B. Small to normal. C. Consistent with early failure. 2. If you were to see calcifications in the abdomen (none are present in this case), they would probably be caused by which of the following? A. Previous adrenal hemorrhage. B. Gallstones. C. Splenic granulomas. 3. Is there evidence of hyperinflation? A. Yes . B. No. 4. Do you see acute findings? A. Yes. B. No. C. Cannot be determined. 5. Which of the following organisms are common culprits in this condition? A. Pseudomonas aeruginosa. B. Burkholderia cepacia. C. Staphylococcus aureus. D. All of the above, and then some.
Left-Sided Appendicitis With Intestinal Malrotation
January 1st 2008In the ED, the patient was afebrile. The pain remained localized to the left lower quadrant; it increased with palpation and decreased when the child lay still. A transabdominal pelvic ultrasonogram was normal: specifically it showed no ovarian torsion.
Down Syndrome in a 1-Day-Old Girl
January 1st 2008On morning rounds in the well-baby nursery, a nurse brings your attention to a 1-day-old girl who is having trouble latching on to the breast. You examine the child and note subtle physical anomalies. The child also has a pronounced head lag and a systolic heart murmur.
In Bacterial Meningitis, Can Dexamethasone Help?
December 1st 2007Adjunctive therapy with dexamethasone should be considered in selected cases of bacterial meningitis in infants and children. Dexamethasone has reduced hearing impairment in children with Haemophilus influenza type b meningitis when given with or before starting antimicrobial therapy.
Are Late-Preterm Infants Mature Enough?
December 1st 2007In addition to term infants (born after at least 37 weeks' gestation), many hospitals currently consider late-preterm infants (born between 34 and 36 weeks' gestation) mature enough to be admitted to the well-baby nursery. Several studies, including one recently published by Young and colleagues1 from Utah, have shown an increased mortality among these late-preterm (also known as near-term) infants.