FATIGUE
You are evaluating a 12-year-old boy who has been fatigued for 2 weeks. His mother reports that he had an upper respiratory tract infection 2 weeks ago, and his appetite has…
LGA BABY
A large-for-gestational age newborn girl who was born via caesarean section for breech presentation is ready for discharge from the newborn nursery at 72 hours of age. She has had an entirely…
scoliosis
A 14-year-old girl comes to your office because her mother is concerned about scoliosis. The mother had mild scoliosis as an adolescent, but she did not require treatment. The girl is…
Valproic acid: is a substrate for CYP 450 2C19 isoenzyme and an inhibitor of CYP 450 2C9, 2D6, and 3A3/4 (weak). It increases amitriptyline/nortriptyline, phenytoin, diazepam, and phenobarbital levels. Concomitant phenytoin,…
nocturnal enuresis
Urinary incontinence is a common problem in children. At five years of age, 15 percent of children remain incompletely continent of urine. Most of these children have isolated nocturnal enuresis…
preauricular sinus,branchial cyst
A full-term newborn was delivered after an uneventful pregnancy to a gravida 2, para 2 woman by normal spontaneous vaginal delivery. His birth weight is 3,150 g. Findings on physical…
nystagmus
You are evaluating a 4-year-old boy who complains of “bouncing eyes:’ His mother reports seeing his eyes jiggle for a few seconds at a time. There are no abnormal head,…
sickle cell anemia
A medical student is working with you in clinic. He is preparing to see a 2-month-old infant whose older sister has sickle cell disease. The infant’s medical record has the…
congenital hypothyroidism
You are called by your state newborn screening program for a low total thyroxine (T4) level found on newborn screening. The level was drawn 24 hours after a term, healthy…
MALROTATION
on day old infant has vomiting and abdominal distension.baby has passed meconium. Bilious vomiting, usually with some abdominal distention, occurs in a baby who passed normal meconium and has an open…