By Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph Raine, Joanna Walker
The hot version of this best-selling identify from the preferred a hundred instances sequence explores universal paediatric situations that would be encountered via the scientific pupil and junior physician in the course of sensible education at the ward, within the emergency division, in outpatient clinics and locally, and that are more likely to characteristic in qualifying examinations. The publication covers a complete diversity of shows from cough to constipation, geared up by way of sub-specialty quarter for ease of reference. finished solutions spotlight key take domestic issues from every one case and supply functional suggestion on the best way to take care of the demanding situations that take place whilst working towards paediatric medication in any respect degrees.
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Additional resources for 100 Cases in Paediatrics
45 s. 52 s. 42 Cardiology KEY POINTS • The commonest cause of fainting in a teenager is neurally mediated (vasovagal) syncope. • Cardiac causes should always be considered in the differential of epilepsy and funny turns. • An ECG is almost always indicated. 43 This page intentionally left blank ENDOCRINOLOGY AND DIABETES CASE 14: A THIRSTY BOY History Steven is a 4-year-old boy seen in the paediatric day unit with a 2-week history of polydipsia and polyuria. Having been dry at night for some time, he has also started wetting the bed.
KEY POINTS • Measure oxygen saturations if you have any suspicion that a baby may be cyanosed. • The absence of a murmur does not exclude congenital heart disease. 30 CASE 10: A SHOCKED NEONATE History Freddie is 3 days old. He is brought by ambulance to the resuscitation room in A&E. He was found in his cot this morning looking mottled and breathing very fast. He had been well until yesterday when he did not feed as well as usual. He was born at 39 weeks’ gestation by normal vaginal delivery in a midwife-led birthing unit and was discharged home the same day.
Fluid restrict even if no hyponatraemia, as SIADH may still develop Fluid balance, regular urea and electrolytes – adjust fluids accordingly. g. bubble blowing. Encourage mobility Monitor for development of a pleural effusion. If the chest X-ray is suspicious, an ultrasound will be diagnostic. If present, a longer course of antibiotics is recommended to prevent empyema (a purulent pleural effusion). A chest drain may be necessary if there is worsening respiratory distress, mediastinal shift on the chest X-ray, a large effusion or failure to respond to adequate antibiotics Ensure adequate nutrition – children have often been anorectic for several days.