Pediatric Commons

Story

A 15-month-old caucasian male came to clinic for his health supervision visit. He was developing and growing normally and his parents had no concerns. He was taking a mixed diet appropriate for his age with ~20 ounces of whole milk daily. The pertinent physical exam showed a healthy appearing male with growth parameters at the 75% and a normal examination. His screening laboratory evaluation showed a hemoglobin of 10.6 mg/dL.

The new intern…

Story

A 5-year-old male came to clinic with a history of ~ 7 days where he would have emesis. The episodes occurred at random times usually at least 1 or more hours after he had eaten. He denied nausea and was still hungry but he would not eat as much as usual. The emesis did not have blood or mucous and was of the food and beverages he had…

Story

A 5-year-old female came to clinic with a history of acute pharyngitis that was positive for Group A, β-hemolytic Streptococcus. When reviewing her medications and allergies, the resident noted that she was allergic to ibuprofen and her mother said that she had problems breathing and an urticarial rash twice after receiving ibuprofen that required her to go to the emergency room. The mother said that she used acetaminophen for pain and fever relief without any…

Story

A 13-year-old female came to clinic with a complaint of recurrent wounds on her buttocks. These occurred over the past 3 months and had been getting worse during the summer. She and a friend had been training for a 7-day bike trip and had been increasing their mileage considerably over the past 2-3 weeks. She said that there had been several sore spots that changed in location over time but she now had two that were particularly painful and were not healing. She…

Story

A 2-year-old female came to clinic for her well child check. The parents had no concerns and she was developing normally. The past medical history was non-contributory. The pertinent physical exam showed a healthy female with growth parameters in the 75-90%.

The diagnosis of a healthy female was confirmed. The parents asked about when to begin toilet training. The pediatrician recommended to follow the child's cue and when she seemed…

Story

An 8-month-old white male came to the emergency room with his mother visibly upset. She had been in the grocery store, when a well-meaning person asked her if she knew that her son was very yellow-colored. The mother recognizing this for the first time panicked, grabbed him from the cart and came immediately to the emergency room located a few blocks away. The past medical history revealed a previously full-term, healthy infant who had been gaining weight…

Story

A 15-year-old female came to clinic for her health supervision visit. During the visit she said that although her periods were regular she had heavy bleeding that was interfering with running and swimming. She said that she would soak a pad and tampon every hour during the first 1-2 days then for the next 1-2 days she would soak a pad and tampon every 2-3 hours. On days 5-6 she would soak a pad or tampon every 6 hours. She said she had some cramping on day 1 of her…

Story

A 5-year-old male came to clinic with a history of constipation and anal itching. The anal itching had been occurring for over 1 month and was worse at night. He would wake his mother because of the itching and scratching. His mother said he had scratches on his bottom that then became so sore that the patient began to retain his bowel movements because of the irritation and soreness. This had been happening for about 2 weeks. "His cousin had pinworms a few months…

Story

A 3-year-old male came to clinic with a fever to 102°F, mouth sores and a rash. The mother said that the fever had started the day before and this morning he had the rash and mouth sores. He was not taking much fluid in the morning but had been urinating. He had been previously well and there was known Hand-Foot-Mouth disease in the community.

The pertinent physical exam showed a wary male who was drooling. His temperature was 101.7° with other vital…

Story

A 9-year-old female came to clinic in the morning with a headache that began 4 days previously after a fall at school onto a concrete surface. The patient had been pushed down backwards and hit the posterior part of her head.

Witnesses and the patient denied loss of consciousness but the patient said she was slow to get up.

Ice was applied and the patient returned to her class, but a headache made her go to the school office and her parents were called to…