CC: 9mo male with fever and toe redness HPI: 9mo otherwise healthy boy presents with acute onset fever and great toe redness. Per mother, great toe was noted to be red and swollen at daycare about 2 hrs prior to presentation. She did not notice it in the morning when getting him dressed. When mother […]
Author: Mary Beth Howard
Hot Seat #148: Denouement
The case: a 4 mo with history of bilateral nephrectomies on daily dialysis presenting with hyperkalemia that is worsening over ED course with evidence of repolarization abnormalities on EKG. Here’s how you answered the questions: Discussion: In a child with chronic hyperkalemia and a normal EKG with plans for upcoming dialysis, how aggressively (if at […]
Hot Seat Case #138 Denouement: 8 mo F with respiratory distress
Mary Beth Howard, MD, Children’s National Medical Center The Case: A 8 mo F presenting with respiratory failure and epistaxis, with difficulty oxygenating, anemia, and persistent coffee-ground emesis Here’s how you answered the questions: What are your top 3 differential diagnoses?Less than 3 years PEM experience (12 responses): Bronchiolitis NAT Thrombocytopenia bleeding diathesis NAT Malignancy […]
Hot Seat Case #137 Denouement: 5 wk M with ear drainage
The Case: A 5wk old ex FT boy presenting with bilateral ear drainage and fussiness without fevers and otherwise normal exam Here’s how you answered the questions: Discussion: Ahhh babies. Their peculiar behaviors can be nothing (i.e. seborrheic dermatitis that extends to the external auditory canal with inflammation) or everything (SBI). In this case of […]
Hot Seat Case #137: 5 wk M with ear drainage
Mary Beth Howard, MD, Children’s National Medical Center with Karie Button, MD, Children’s National Medical Center CC: 5 wk old M with b/l ear drainage and fussiness HPI: 5 week old ex FT boy presenting with 1 day of bilateral ear drainage. Father reports it started the day PTA. Discharge is yellow/clear. Coming from both […]