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(Click the link to comment and to vote – voting not working through email, sorry!) Parents bring in their 11 month old baby for a new-onset rash. The baby is unimmunized by parent choice. The baby had fever for the… Continue Reading →
You are seeing a 6 year old girl who comes in for right leg pain after a ground level fall at the park. She is currently being worked up by her pediatrician for precocious puberty, including vaginal spotting and breast… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 14 month old who has a two irregularly oval yellow-tan lesions on his right upper arm, just under 1cm each. They… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!)A You are seeing a 3-year-old boy with 2 days of fever to a maximum of 102.7 F, an urticarial rash (but no enanthem), and significant… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are evaluating a 10 year old patient who had a bone marrow transplant 2 months ago. The patient is presenting with low-grade fever, a… Continue Reading →
Managing parent expectations is half of pediatric emergency medicine. When parents bring in kids with worsened eczema (either as a chief complaint or a side complaint), they are often frustrated that they used the prescribed cream, things got better, but… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an 18 month old girl with chief complaint of itchy scalp and rash at the nape of her neck just below her… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) It’s summertime, and you are seeing a 15 month old with fever and papulovesicular lesions on the palms, lateral borders of the feet and soles,… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an 8 year old boy with the pictured lesion. He has had it for 2 months; it is slowly growing, and occasionally… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 3 day old infant with a new onset rash on the chest and abdomen. The baby was born full-term with no… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an 8 year old girl who was prescribed an oral cephalosporin antibiotic 1 week ago for rhinitis. She has 3 more days… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10 month old infant with one day of fever, purpuric rash, and subcutaneous edema of bilateral extremities. He was seen in… Continue Reading →
Here’s a great tip from one of our PEM fellow’s recent lectures. When a patient has cellulitis that’s being treated as an outpatient, we often outline the area of erythema with a pen so the parent can know if the… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 3 year old ill-appearing child with high fever and rash. She initially started with tender erythema in her skin folds, progressing… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 6 year old boy presents with 2 days of nontender palpable purpura of bilateral lower extremities, accompanied by arthralgia of the left ankle. Vital… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a previously healthy 9-month old boy brought in for rash. The child had 3 days of fever. He was seen yesterday evening… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 13 month old with a rash for 3 days. It started as fluid-filled vesicles that grew, burst, and released clear-yellow non-purulent… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) A 12mo old child with immunizations up to date presents with fever and rash. Which of the following distributions is concerning for measles?
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a child with fever and rash x 1 day. Cognizant that we are in the middle of a measles outbreak, which of… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 19 year old otherwise well-appearing man presents with 2 days of headache, anorexia, tactile fever (but afebrile in the ED), and 1 day of… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Which of the following topical antibiotics has the least efficacy against impetigo? (see pictures of impetigo here and a short article here)
(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… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 2 year old child has a flat lesion of the entire left forehead and upper eyelid the color of light red wine that has… Continue Reading →
(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,… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 17yo boy presents with a round lesion similar to that noted below, but on his penis, noted 1 hour after taking a dose of… Continue Reading →
(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… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 9 month old baby is brought in with this problem, first noted a few hours prior. By James Heilman, MD [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 2 year old is brought in because all of his fingernails and toenails are falling off, painlessly. On review of the ED electronic medical… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 17 year old boy comes is brought in to the ED at 2am for severe retrosternal chest pain that awoke him from sleep. He… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Which of the following is true about erythema multiforme major, Stevens-Johnson syndrome, and toxic epidermal necrolysis?
http://diseasespictures.com/ What is the best treatment for this 3 year old patient’s rash? (Click the link to comment and to vote – voting not working through email, sorry!)
A family obtained tuna from the local farmer’s market and prepared it for dinner. The children thought the fish tasted weird, peppery or metallic, but the parents did not, and told the children to stop complaining and eat dinner. Within… Continue Reading →
A 10yo girl comes home from a family vacation to Florida in June, where she swam in the ocean. She has an itchy rash in the area covered by her bathing suit that started soon after swimming in the ocean… Continue Reading →
Use a glass test tube or specimen tube to press on a rash to see if it blanches – remember, petechiae and purpura don’t blanch. You can also use a glass test tube as a mini-anoscope to blanch surrounding mucosa… Continue Reading →
Measure your fingernails to see which is closest to 1cm – now you will always have a 1cm “ruler” with which to measure lesions, lacerations, discolorations, etc.
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