Author: Mary Beth Howard

The Case: a 24 yo M with progressive posterior fossa pilocystic astrocytoma presenting from Oncology clinic with altered mental status and respiratory failure whose father is resistant to medical interventions. Here’s how you answered the questions: Discussion: This case represents multiple challenges, mostly resulting from dealing with an altered adult patient with unclear advance directives […]

The Case:  a 12 yo healthy boy presenting with exertional chest pain associated with SOB/incr WOB with exam notable for tachypnea, clear lungs, EKG NSR, and normal CXR.  Here’s how you answered the questions: Discussion A challenging case given the nonspecific history, exam, and work up. For initial steps, the majority would obtain an EKG and CXR and trial […]

The Case: Dr. Patel said it beautifully: “a full term, well appearing, thriving 7 day old infant presenting with frankly bloody stools without other systemic symptoms such as vomiting, fever, jaundice, pallor or irritability; with normal vitals and exam but questionable pneumatosis on AXR.” Here’s how you answered the questions: Discussion: Ahh the classic infant […]

Jonathan Lee, MD, Inova Fairfax Children’s Hospital with Shilpa Patel, MD, MPH, Children’s National Medical Center HPI: 10 day old male infant presenting to the ED from their Pediatricians office due to concerns for bloody stools. Bloody stools started at 7 days of life. Was intermittent at first, but has become more frequent and large. […]

The Case: A 22 mo boy with acute on chronic knee pain, with normal exam and work up in the ED notable for mildly elevated inflammatory markers and normal imaging. Here’s how you answered the questions: Discussion: The major dilemma in this case how much of a work up for a chronic compliant with recent […]