A 4 week old male is brought to the Emergency Department with a recent history of several projectile non-bilious non-bloody emesis during the last few days. You obtained some labwork and image studies. The lab results show the following: Na =139 mmol/L, K = 3.4 mmol/L, Cl = 94 mmol/L, CO2 = 34 mmol/L. The most likely diagnosis is:
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A 12-month-old non-ambulating toddler presents to the ED wit…
A 12-month-old non-ambulating toddler presents to the ED with a spiral fracture of their left tibia/fibula and a bruise on their right cheek. After completion of the primary assessment, appropriate interventions and stabilization, the next diagnostic evaluation should include:
Appropriate treatment for pelvic inflammatory disease (PID)…
Appropriate treatment for pelvic inflammatory disease (PID) in an adolescent includes:
A 15 year old female presents with a 3 day history of sore t…
A 15 year old female presents with a 3 day history of sore throat, trismus, and dysphagia. She presents to the ED today with unilateral neck swelling. A CBC reveals a white blood cell count of 24,000. Which of the following is the most likely diagnosis?
A 10 year old female underwent a laparoscopic appendectomy f…
A 10 year old female underwent a laparoscopic appendectomy for perforated appendicitis with extensive peritonitis. He is currently postoperative day # 2, drinking clear liquids, and taking oxycodone and acetaminophen as needed for pain control. On morning rounds, it is noted that her abdomen is distended and seems more uncomfortable than past exams. The bedside nurse reports that he had one emesis this AM. What is the most likely finding based on history and physical examination?
You are a PNP in a busy tertiary PICU caring for an 8 year o…
You are a PNP in a busy tertiary PICU caring for an 8 year old admitted for dehydration secondary to feeding intolerance. History includes birth at 24 weeks gestation, cerebral palsy, profound developmental delay and GT dependence. The GI service was consulted and recommended strict NPO for 7-10 days. To provide adequate caloric and nutritional intake, you decide your patient requires total parenteral nutrition (TPN), and subsequently undergoes PICC line placement. The following statements are true regarding this clinical scenario except:
An 11 month old female is brought to the emergency departmen…
An 11 month old female is brought to the emergency department with an acute onset of intermittent, colicky abdominal pain, vomiting, lethargy, and “currant jelly” stools. Which of the following is the most likely diagnosis?
A 3 week old presents to the ED with a 2 day history of poor…
A 3 week old presents to the ED with a 2 day history of poor feeding, decreased urine output, and lethargy. On exam, it is noted that he has a bulging fontanelle. The child was born via spontaneous vaginal delivery and was discharged to home with mom on day 2 of life. In the ED, he was found to have a body temperature of 39.0 C (102.2 F). Before you prepare for a lumbar puncture, you are considering obtaining a CT scan of the head first. Why would this be indicated?
Following surgery for a brain tumor, your 2 year old patient…
Following surgery for a brain tumor, your 2 year old patient’s lab work shows a Na of 122 and serum osmo of 236. You cannot do an accurate neuro assessment due to the patient being intubated, sedated and paralyzed. What would be your next course of action?
Which of the following has a similar sedative effect as prop…
Which of the following has a similar sedative effect as propofol?