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Sinai Daily Pearl 10/25

An infant is brought in with increased irritability x 2 days. The parents note that she hasn’t had any remarkable symptoms – no fever, cough, congestion, vomiting, diarrhea. She is tolerating feeds, but more fussy than usual. Your initial exam is normal. The mother later directs you to take a closer look at the infant’sRead more

The Vomiting Child – Multiple Choice Q&a

1. A 14 month old child is brought into the ED for fevers, vomiting, diarrhea x 4 days. Stools are watery and nonbloody. The infant appears nontoxic and well hydrated. The patient attends day care. What is the most likely diagnosis? a) Campylobacter b) Rotavirus c) Shigella d) Salmonella e) Norwalk virus 2. A 3Read more

An upset mother arrives in the Peds ED saying that her 2 yo son swallowed one of her “pressure pills.” Which antihypertensives can be single dose killers for a young child?Read more

10 y F p/w right neck pain starting last night, she has decreased ROM with her head tilted to the left. atlanto-axial subluxation on CT This child has atlanto-axial subluxation, sometimes called Grisel syndrome. The key to identifying this condition and differentiating it from torticollis caused by muscle spasm is the relationship between head positionRead more

Bonus Peds Pearl

Summer!! I love summer!! Its a beautiful, gorgeous day in the big bad city! Beware the T-storms later tonight! Thanks to Dr. Elizabeth Weinstein from Indiana University School of Medicine for a riveting and wonderful lecture on potentially lethal diseases with easy-to-miss signs and symptoms. In the same vein, I would like to present aRead more

Pediatric 04/09/2013

Good morning, hope you all enjoyed last nights exciting NCAA Men’s Basketball National Championship. For those who are interested and wonder what I thought of it, please refer to bottom of page. Today its going to be a gorgeous 77 degree weather today, break out your sunscreens! Low tonight of 59. Tomorrow, high of 80Read more

Clinical Picture

A 4 year old boy presents with the above findings. What is it and how do you treat it?Read more

Clinical Pearl: July 24

A 14 year old male presents with gradual onset headache with blurry vision, photophobia, and right forearm “tingling.” He has had similar headaches previously, and this does not represent his worst headache. No neck stiffness. Comprehensive neuro exam is normal, visual acuity is 20/20 with no field deficits. No objective findings on physical exam. YouRead more

Clinical Pearl: July 17

An 11 day old infant presents to the ED with persistent emesis after every feed, along with progressive yellowing of skin since birth and a 30% weight loss since birth. Physical exam reveals normal vital signs and a jaundiced, slightly lethargic baby with notable hepatomegaly. Parents report that the baby’s newborn metabolic screening has notRead more

E M Pearl, May 22

Thank you to Dr. Chris “This Ain’t No Simulation” Strother.   3 kids, 3 head injuries.   A) 2-month old boy, fell out of baby carriage onto top of head 30 minutes ago. No LOC, seizure, vomiting. Acting normally per mom. Abrasion on superior scalp, no palpable skull fracture, fontanelle flat.   B) 18-month oldRead more