peds osces

8/15/2019 Peds Osces

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Pediatrics

1. febrile sz2. chronic cough, frequent URIs

3. FTT

4. neonatal aundice!. "ri# nocturnal enuresis

$. colic

%. &o#iting'. language dela(

). i##unization counselling

1*. "eanut allerg(

11. diarrhea12. diabetes

+ou"let station

T- /0. FR F +/I 5IT/ F6RI 7I8UR9

PP9 0, T RI7- F R+URR:+, T /5 T :; FUTUR 7I8UR

T- /I7TR< FR T/R F +/I 5IT/ +/R:I+ +U;/U:R7P:7I= T 60

PP90, -< /0. :T7, I:=7TI;TI:7

2 > son has "ersistent cough after ha&ing URTI 3 ?ee@s ago treated ?ith a#oAil andantitussi&es. +hild had histor( of ato"(. 5heezing. +ough ?orse at night. 5ife

s#o@es. I##unizations intact. :o one else sic@ in fa#il(. Hx only. PAEDS

PP9 1. 5hat is (our diagnosis Breacti&e air?a(sC2. 5hat su""orts it on histor( B?heezing, ato"(, ?orse at nightC

3. 3 #anage#ent o"tions Bbronchodilators, inhaled steroids, "arents sto"

s#[email protected]

=isit #other ?ho has gi&en birth $ hours earlier to a full ter# bab( ?eighing less than !

lbs. Focussed histor(.

6. dA. D, D

:eonatal Eaundice histor( and questions about causes and tests

Pri#ar( nocturnal enuresis in a ) (ear old9 histor( and causes


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to orderD utline (our #anage#ent of this "t. 5hat are three factors that ?ould "ut this

child at ris@ of abuseD BThis ca#e out of no?here for all of us I said fe#ale child, (oung

#other, first bab(, #other o&er?hel#ed, or so#ething li@e that.C (ear old daughter ?ho is still at ho#e is not using

co#"leA sentences. Eust using single ?ords. Re"eated otitis #edia. ll other #ilestones

o@a( and no social deter#inants abuse identified on histor(. 6rother ?ho is ! is o@a(.

other concerned she is de&elo"#entall( dela(ed. Question : what is your Dx

(hearing loss). History only. PAEDS

1* (ear old child ?ith frequent URIOs, in toda( ?ith one. Ph(sical eAa# and address "arentOs concerns.

I##igrant ?o#an ?ho has $ ?ee@ old bab(. /er friends ha&e told her that he needsshotsQ. /er #other has told her that the shots har# the bab(. +ounsel.

Foster #other of 1* #onth old child she has cared for for four #onths.

Bots of foursC. 7he is co#"laining the bab( has had ' ?ee@s diarrhea.


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Rele&ant hA. :o #edical hA a&ailable on the bab(. n questioning, (ou find out the(

ha&e been gi&ing the bab( all @inds of ?eird stuff including adult food, and she had so#e

diarrhea ?ith #il@ and uice. :o other s(#"to#s. t nine #inutes, (ou are as@ed fort?o "otential diagnoses, and ?hat (ou ?ould do if the bab(Hs #other called that afternoon

and as@ed for infor#ation on the bab(Hs condition. I said this could be toddlerHs diarrhea

and lactose intolerance, but I thin@ I ?ould ha&e been better to sa( ?hat I found on #(questioning, that the diet is too ad&anced for the bab(.

$ (ear old bo( brought to R because of acute 76 and li" s?elling after ha&ing a "eanut butter sand?ich. Treated ?ith e"ine"hrine and antiNhista#ines and is no? stable and

read( to go ho#e. Parent ?ants to tal@ to (ou about ana"h(laAis. d&ise and counsel.

Findings: otherwise healthy kid who got hives with penicillin, no family history of atopy,

mother wants to know symptoms to look out for, what to do ne%t time, etc. &dviseregarding use of epi'pen, medications, etc.

-id ?ith iabetes

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