Blog

You are seeing a 4-year-old patient with intermittent fevers…

You are seeing a 4-year-old patient with intermittent fevers x 2 weeks and right knee swelling. On physical exam, she is afebrile, well appearing, abdomen is soft with hepatic edge 4cm below the costal margin. Right knee is swollen and warm without erythema, tenderness, or effusion, but with decreased ROM. You suspect JIA and order labs.: WBC 15k Platelets 470k ANA positive Which of the following statements is true:

A 4-year-old presents to your clinic with multiple petechiae…

A 4-year-old presents to your clinic with multiple petechiae and bruises overhis entire body. His mother denies any history of trauma but reports he is avery active child. He is currently afebrile, but mom reports he had URIsymptoms about a week ago. Otherwise, his past medical history isunremarkable. Aside from the petechiae and bruises, his exam is otherwisenormal. You order a CBC. Based on the results, the most likely diagnosis is: Hemoglobin 11.4WBC 10.5k with normal differentialPlatelets 20k

A 6-month old fell out of her high chair onto the kitchen fl…

A 6-month old fell out of her high chair onto the kitchen floor three hours ago and is brought to the ED by her parents. Parents report no loss of consciousness, vomiting, or seizure activity. She seems increasingly drowsy and has been fussy and refusing feeds. Her physical exam is normal, with the exception of a left frontal hematoma. Which of the following should be considered next in the plan of treatment?

A 9-month-old boy is brought by his parents for evaluation o…

A 9-month-old boy is brought by his parents for evaluation of an abdominal mass that they noticed when changing his diaper. On exam, he appears non-toxic and has a palpable, nontender RUQ mass measuring 4×6 cm. Which of the following studies is most likely to reveal the diagnosis?

A 10-month-old boy present for complaints of “screaming epis…

A 10-month-old boy present for complaints of “screaming episodes” for the past 24 hours. He appears well except for episodes of screaming with flexion of the hips and knees about every 25-30 minutes. The episodes last < 1 minute and he appears well again right after. He has had 2 episodes of non-bilious vomiting. Parents deny fever, blood in stool or vomit. Vital signs and hydration are normal. On exam, he has hyperactive bowel sounds in the right upper quadrant. His abdomen is not notable tender. Rectal and stool exams are negative for blood. What is the BEST next step in management?