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15 Cards in this Set
- Front
- Back
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20-day-old M presents with fever, decreased breastfeeding,and lethargy. He was born at 36 weeks as aresult of premature rupture of membranes.
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Neonatal sepsis
Meningitis Pneumonia Pyelonephritis Physical exam CBC Electrolytes Blood culture LP—CSF analysis CXR UA, urine culture |
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3 yo M presents with a 2-day history of fever andpulling on his right ear. He is otherwise healthy, andhis immunizations are up to date. His older sisterrecently had a cold. The child attends a day carecenter.
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Acute otitis media
URI Meningitis Pyelonephritis Physical exam (including pneumatic otoscopy) CBC Blood culture Tympanocentesis culture LP—CSF analysis UA, urine culture |
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12-month-old M presents with fever for the past 2days accompanied by a maculopapular rash on hisface and body. He has not yet received the MMRvaccine.
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Measles (or other viral exanthem)
Rubella Roseola Fifth disease Varicella Scarlet fever Meningitis Physical exam CBC Viral antibodies/titers Throat swab for culture LP—CSF analysis |
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4 yo M presents with diarrhea, vomiting, lethargy,weakness, and fever. The child attends a day carecenter where several children have had similarsymptoms.
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Gastroenteritis (viral, bacterial, parasitic)
Food poisoning UTI URI Volvulus Intussusception Physical exam Stool exam and culture CBC Electrolytes UA, urine culture AXR |
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1-month-old F is brought in because she has beenspitting up her milk for the last 10 days. The vomitingepisodes have increased in frequency andforcefulness. Emesis is nonbloody and nonbilious.The episodes usually occur immediately after breastfeeding.She has stopped gaining weight.
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Pyloric stenosis
Partial duodenal atresia GERD Gastroenteritis Hepatitis UTI Otitis media Physical exam CBC Electrolytes U/S—abdomen Barium swallow pH probe Endoscopy AST/ALT/bilirubin/ alkaline phosphatase UA, urine culture Tympanocentesis culture |
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3 yo M presents with constipation. The child hashad 1 bowel movement per week since birth despitethe use of stool softeners. At birth, he did not passmeconium for 48 hours. He has poor weight gain.There is a family history of this problem.
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Hirschsprung’s disease Low-fiber diet
Anal stenosis Hypothyroidism Lead poisoning Physical exam Rectal exam Stool exam and culture Barium enema Suction rectal biopsy Anorectal manometry TSH, FT4 CBC Electrolytes Serum lead level |
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8-month-old F presents with sudden-onset colickyabdominal pain with vomiting. The episodes are 20minutes apart, and the child is completely well betweenepisodes. She had loose stools several hoursbefore the pain, but her stools are now bloody.
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Intussusception
Appendicitis Meckel’s diverticulum Volvulus Gastroenteritis Enterocolitis Blunt abdominal trauma Physical exam Rectal exam, stool for occult blood CBC Electrolytes Contrast enema U/S—abdomen CT—abdomen |
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7 yo M presents with abdominal pain that is generalized,crampy, worse in the morning, and seeminglyless prominent during weekends and holidays. Hehas missed many school days because of the pain.Growth and development are normal. His parentsrecently divorced.
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Somatoform disorder
Malingering Irritable bowel syndrome Lactose intolerance Child abuse Physical exam CBC Electrolytes U/S—abdomen CT—abdomen Amylase, lipase Stool exam |
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2-month-old M presents with persistent crying for2 weeks. The episodes subside after passing flatus oreructation. There is no change in appetite, weight,or growth. There is no vomiting, constipation, or fever.
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Colic
Formula allergy GERD Lactose intolerance Strangulated hernia Testicular torsion Gastroenteritis Physical exam Rectal exam, stool for occult blood U/S—abdomen U/S—testicular |
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3 yo F presents with a 3-day history of “pink eye.” Itbegan in the right eye but now involves both eyes.She has mucoid discharge, itching, and difficultyopening her eyes in the morning. Her mother hadthe flu last week. She has a history of asthma andatopic dermatitis.
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Bacterial conjunctivitis
Viral conjunctivitis Keratitis Seasonal allergies Uveitis Physical exam Ophthalmoscopic eye exam CBC Electrolytes Discharge cultures Slit lamp exam |
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14 yo M presents with short stature and lack of sexualdevelopment. His birth weight and length werenormal, but he is the shortest child in his class. Hisfather and uncles had the same problem when theywere young, but they are now of normal stature.
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Constitutional short stature
Growth hormone (GH) deficiency Hypothyroidism Chronic renal insufficiency Genetic causes Cystic fibrosis Physical exam CBC Electrolytes GH stimulation test IGF-1, IGFBP-3 levels TSH, FT4 XR—hand U/S—renal and cardiac Sweat chloride testing BUN/Cr Karyotype |
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9 yo M presents with a 2-year history of angry outburstsboth in school and at home. His mother complainsthat he runs around “as if driven by a motor.”His teacher reports that he cannot sit still in class,regularly interrupts his classmates, and has troublemaking friends.
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Attention-deficit hyperactivity disorder (ADHD)
Oppositional defiant disorder Manic episode Conduct disorder Hyperthyroidism Physical exam Mental status exam TSH, FT4 EEG |
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12 yo F presents with a 2-month history of fightingin school, truancy, and breaking curfew. Her parentsrecently divorced, and she just started school in anew district. Before her parents divorced, she was anaverage student with no behavioral problems.
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Adjustment disorder
Substance intoxication, abuse, or dependence Manic episode Oppositional defiant disorder Conduct disorder Physical exam Mental status exam Urine toxicology |
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15 yo M presents with a 1-year history of failinggrades, school absenteeism, and legal problems, includingshoplifting. His parents report that he spendsmost of his time alone in his room, adding that whenhe does go out, it is with a new set of friends.
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Substance abuse
Conduct disorder Oppositional defiant disorder Adjustment disorder Urine toxicology Mental status exam Physical exam |
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5 yo M presents with a 6-month history of tempertantrums that last 5–10 minutes and immediatelyfollow a disappointment or a discipline. He has notrouble sleeping, has had no change in appetite, anddoes not display these behaviors when he is at daycare.
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Age-appropriate behavior ADHD Oppositional defiant disorder
Physical exam Mental status exam |
