(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an 11-year-old uncircumcised boy whose foreskin became retracted over his glans penis, and then stuck (paraphimosis). It has been this way for… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) A 6 month old female infant is referred in from PMD for concerns regarding the GU exam. Physical examinations at the 2 and 4 month… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 5 year old boy with abdominal pain. His parents say that he has not been eating solids, but has been taking… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 14 year old boy who presents with sudden onset of left scrotal pain and swelling, starting 4 hours prior to presentation…. Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 5 year old girl who presents with dysuria and small amounts of blood in her underwear for 3 days. She has… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies 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 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!) A 4-year old boy is brought in because of marked edema and pruritis of his penis and foreskin. His family is visiting on vacation and… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 15yo girl with a strong family history of nephrolithiasis who presents with colicky right flank pain, non-bloody non-bilious vomiting twice, and… Continue Reading →
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A trio of recent publications on pediatric UTI offer some insights. First, Mattoo et al offer a review of UTI diagnosis and management in children. Nadeem et al studied the optimal WBC cutoffs for diagnosing UTI, balancing overdiagnosis/overtreatment with underdiagnosis/missed UTIs, based on the… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 4 year old boy with PMH of two UTIs and frequent episodes of otitis media. He has dysuria, frequency, straining to… Continue Reading →
To remember the difference in antibiotic regimens for chlamydia cervicitis / urethritis vs pelvic inflammatory disease, rap this in your head: Ceph 10 x 50 for GC is nifty; give Zith 1 gram for the chlam, but doxy 14 days… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 2 year old boy with complaint of penile pain for 2 days. He is previously healthy, fully immunized, afebrile, and has… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) An 8yo boy presents with dribbling urination and pain with urination. When he urinates he sees his foreskin balloon out. On exam, he has phimosis…. Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) A 19yo man was seen in the ED 2 weeks ago with a painless lesion to his penis. He is sexually active with men, has… Continue Reading →
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Staying with the topic of urine… investigators at University of Pittsburgh have derived and validated a UTI risk calculator for patients aged 2-23 months. The calculator (UTICalc) is linked from the On Shift page of PEMsource under the heading Neonatal… Continue Reading →
Nothing slows down the ED flow like waiting for the urine flow of an infant or toddler. Whether or not to screen for UTI with a clean catch urine vs obtain a catheterized specimen will be left for another discussion,… 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 5 year old uncircumcised boy is brought in because his parents are concerned that they cannot retract his foreskin. On exam he has phimosis,… Continue Reading →
Your local hospital cafeteria can be a useful resource in managing your PED patients: Sugar liberally applied to the edema of a paraphimosis or rectal prolapse may help decrease swelling and improve reduction efforts A mayonnaise packet provides useful lubricant… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 15 year old girl is brought in by her uncle for a chief complaint of vaginal discharge (he explains that her parents are working… Continue Reading →
A young girl comes in c/o dysuria and the urine is stone cold normal. What else can explain her symptoms? (BTW, you must do a GU exam at this point). Adhesions (labial) Bubble bath (and other soaps, irritants) Candida (particularly… Continue Reading →
A 5yo uncircumcised boy comes in because his parents are unable to retract the foreskin of his penis. They have not been able to retract it ever, but now note also that he is having ballooning of the foreskin when… Continue Reading →
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