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(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 2-month-old infant brought in by parents because they notice the center and mid-back of the tongue is black in color. The… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a well-appearing 20 day old infant brought in for passing 4 stools instead of 6 today. The baby is full term, eating… 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!) Which of the following physical exam findings on a newborn’s sacrum does NOT mandate an MRI to rule out occult closed spinal dysraphism?
(Click the link to comment and to vote – voting not working through email, sorry!) A seven day old neonate is brought in for a fever of 38.5 and lethargy. The baby had a home birth, and the parents have… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 1 week old with the pictured oral lesions.
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10 day old ex-full term infant with bilateral watery mucoid eye discharge, mild eyelid edema, and papillary conjunctivitis. You suspect chlamydial… Continue Reading →
These come from Joe Ravera – creator of great podcast PEM GEMS – the U in BRUE stands for unexplained. So if it’s explainable, it’s not a BRUE. For example, if the baby vomited after eating and then choked on… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 10 day old presents with shaking of bilateral upper extremities and jitteriness. The patient was a term infant born NSVD with no complications. He… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are evaluating a term neonate for hyperbilirubinemia. The baby was sent home at 36 hours of life with a bilirubin measurement of 7.0, and… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 16 year old girl arrives to the ED by ambulance and promptly delivers a 34 weeks by dates neonate. The infant is unresponsive, apneic,… 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 regarding… Continue Reading →
You’ve probably heard… AAP Subcommittee on Febrile Infants came out with new guidelines. The algorithms have been posted on PEMsource algorithms page, and the fever table updated to reflect them. Also, the CDC came out with new guidelines regarding STI… 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 full term infant born out of asepsis (BOA) at home is brought in by ambulance to your PED. No neonatologist or pediatrician is in… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Which child does not meet the criteria for a low-risk BRUE? (Assume for all patients the events are now resolved and resolved immediately after the… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 4 week old infant with non-bilious forceful vomiting x 3 days.
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 5 day old infant born term without complications brought to the ED because the parent noted a streak of bright red… 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!) 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 full term infant with no birth complications and no known risk factors for hyperbilirubinemia complications, discharged early at 36 hours of life, presents to… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10 month old with symptoms consistent with varicella. The infant is well-appearing, has no complications, and is 3 days into her… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 4 week old brought in for vomiting with every feed. The vomitus is non-bilious, non-projectile, and non-bloody. The baby is making… 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 17 year old G1P0 girl at 38 weeks gestation presents in active labor, crowning. OB has been called but is responding from home and… 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!) 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!) An 8 day old male is brought in with bilateral breast enlargement. They seem slightly tender, but there is no redness, fluctuance, or fever. The… 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 6 week old ex-30 4/7 weeks twin A male infant was seen at an outside clinic because his parents felt that his heart was… Continue Reading →
A 36-week infant is born precipitously NSVD to a 17yo G2P1 mother in the ED after the mother presented with the chief complaint of intermittent abdominal pain. Apgars are 8 and 9 at 1 and 5 minutes, with -1 for… Continue Reading →
A 2 month old ex-30 week premie just discharged from the NICU comes in with respiratory distress and hypoxia. You determine that the patient needs to be intubated. The baby’s weight at discharge was 2.5 kg. What size ETT should… Continue Reading →
You are seeing a 6 week old ex-full term infant who is breastfeeding exclusively, having 6 wet diapers per day, 4 or more soft seedy stools per day, growing well, and no fever. Baby has been jaundiced since 1st week… Continue Reading →
It’s RSV season and you’re seeing a 30 day old ex-39 week infant with a runny nose. The resident has ordered a POC RSV, which is positive. The baby is afebrile, feeding well, and nontoxic. Do you admit the infant… Continue Reading →
You’re seeing a 5 day old with a fever of 39. Attempts to get IV access have been unsuccessful. The child is alert and not toxic appearing, but you’d like to get empiric antibiotics started within the first hour of… Continue Reading →
3 week old infant is brought in with fever of 38.5. The baby is well appearing and does not have any high risk factors in the birth history. You plan to get urine, blood, and CSF cultures and give empiric… Continue Reading →
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