PEM Source

Your source for all things Pediatric Emergency Medicine

All posts with tag: "renal"

PEM Questions

(Click the link to comment and to vote - voting not working through email, sorry!) You are seeing a 2 year old who is slowly improving from a bout of acute gastroenteritis manifested by fever, vomiting, diarrhea, and abdominal pain that started 5 days ago. The parent is concerned that he remains less active and appears pale. Vital signs are temperature 37.7, HR 135, RR 24, BP 110/60, O2 sat 99% on room air. Point of care hemoglobin is 6.5 g/dL. [yop_poll id="155"]
(Click the link to comment and to vote - voting not working through email, sorry!) [yop_poll id="151"]
(Click the link to comment and to vote - voting not working through email, sorry!) You have diagnosed a 14 year old boy with likely nephrolithiasis, as evidenced by his colicky flank pain, hematuria, and ultrasound showing mild hydronephrosis. [yop_poll id="115"]
(Click the link to comment and to vote - voting not working through email, sorry!) An 8yo boy presents with a 1 month history of progressive periorbital and generalized facial swelling, worse in the morning. Urine dip is positive for proteinuria. You suspect nephrotic syndrome. [yop_poll id="108"]
(Click the link to comment and to vote - voting not working through email, sorry!) A 6yo girl presents with palpable purpura of both legs for 2 days. She has not had any fever and is well appearing. Her labs, including CBC, electrolytes, BUN, Creatinine, and ESR are normal. She does not complain of any pain. Her vital signs are temperature 37.5 C, HR 90, RR 20, BP 90/45. She has no abdominal tenderness, vomiting, respiratory difficulty, joint pain or swelling, and her urination has been normal. Her stool guaiac is negative. [yop_poll id="62"]

Conundrums

(Click the link to comment and to vote - voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other! Parents bring a 15mo old non-black uncircumcised well-appearing fully immunized male with 3 hours of fever and no other symptoms. His temperature is 39 C. You find no clear source for the fever on exam. It is wintertime and his siblings all have URIs but this patient has no cough or congestion. He has not had any prior UTIs. Do you catheterize him for urine to rule out UTI? [poll id="45"]

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