Pediatric Commons

Story

A 10-year-old male came to the emergency room with double vision. Four weeks previously he was playing baseball and had a sudden attack of double vision. This stopped after a few minutes. The family saw an optometrist who changed his glasses' prescription. The double vision then started to occur at other times, particularly with lateral gaze. He also had headache, nausea and was tripping when walking. He was seen again by the optometrist and referred to the emergency…

Story

An 8-year-old male came to clinic for health supervision. His mother said that he seemed to be on the losing end of verbal playground confrontations and was not being included in organized soccer and football games at school. These were games that he loved to play and there had been no problems until the new school year began. The patient was having no other social problems. The pertinent physical exam showed a healthy male with growth parameters in the…

Story

A 4-month-old female came to clinic for well child care. The mother reported using a bassinet-style co-sleeper next to her bed for the infant to sleep in. She liked this because she could roll over at night and take the infant into her bed to breastfeed and return the infant to the co-sleeper easily. The mother was a non-smoker and non-drinker. The past medical history showed a full-term infant without prenatal or natal problems. The pertinent physical…

Question: What Are the Different Types of Conjoined Twins?

Story

While volunteer teaching in the human body curriculum of a local elementary school, the students asked a pediatrician several questions about twins. They were especially interested in conjoined twins since there had been some recent media stories about a set of conjoined twins. He explained that people weren't sure exactly how conjoined twins happened, but the usual thought was that it was due to cells…

Story

A 1-month-old female came to clinic with a 2 day history of increased vaginal discharge. The mother noted that there was an increase in the amount but that the discharge continued to be clear-colored and have a thin consistency. The mother noted a red rash on the perineum that she had been using a barrier cream on. The infant was otherwise asymptomatic, and the mother had no concerns about potential sexual or physical abuse. The past medical history revealed a…

Story

An 18-month-old male came to clinic with a fever for 2 days to 101° F. He had a runny nose, mild cough and had been pulling his left ear and complaining of pain. The pertinent physical exam showed a mildly ill child with a left tympanic membrane that was red, bulging, with no light reflex and no mobility with insufflation. His right ear was grey with a splayed light reflex and normal insufflation.

The diagnosis of acute otitis media was made and…

Story

A 15-year-old male came to the emergency room with cough, runny nose and fever to 101.5° F for 2 days. The cough was increasing in intensity overall and occurred day and night. There was no paroxysmal quality and the patient said he felt breathless. The past medical history was positive for mild intermittent asthma with the last episode occurring more than 5 years ago. He denied chest pain, myalgia, arthralgia, sore throat, emesis, nausea or…

Story

A 6-month-old male came to clinic with his parents for his well child care. He was bottle-feeding and gaining appropriate weight. The father had many questions about feeding and if canned vegetables could be used for feeding his child. He was already taking some fortified rice cereal without problems. The social history showed that the parents were young, both working and also receiving government assistance through supplemental food and healthcare…

Story

A 15-year-old male came to the emergency room after attempting to commit suicide by hanging. He was found unconscious but breathing by his parents. The pertinent physical exam showed an irregular breathing pattern at 38, heart rate of 62 and blood pressure of 150/94 with a Glascow Coma Scale of 4 with no eye opening or verbal utterances with abnormal flexion and inconsistent withdrawal to pain. Neurological examination showed pupils that were 1-2 mm and…

Story

Patient Presentation

A 2-week-old female came to clinic for well-child care. She was a full-term infant who was breastfeeding and had regained her birth weight. She had no jaundice and appeared to have no problems with hearing or vision. Her parents had family support and were doing well other than being tired. Her neonatal screen had been positive for a Bart's hemoglobin and she had a complete blood count (CBC) done at 1 week was normal for her age and…