A 5-year-old presents with scattered petechiae after a recen…
A 5-year-old presents with scattered petechiae after a recent viral illness. She is well appearing. CBC shows: Lab result Normal range Platelets: 14,000/µL ~150,000–450,000/µL Hemoglobin: 12.4 g/dL ~11.5–14 g/dL for a 5-year-old WBC: 7.8 K/µL ~5–15 K/µL Differential: normal Age-dependent; no abnormal cells/blasts expected
Read DetailsA 9-year-old girl presents with dysuria and urinary frequenc…
A 9-year-old girl presents with dysuria and urinary frequency. She is afebrile and has no flank pain or vomiting. UA shows positive leukocyte esterase and nitrites. She is started on TMP-SMX (Bactrim). Two days later, urine culture grows E. coli>100,000 CFU/mL resistant to TMP-SMX and susceptible to cephalexin and nitrofurantoin. She is still mildly symptomatic.
Read DetailsA 6-year-old is brought to primary care with 2 days of cough…
A 6-year-old is brought to primary care with 2 days of cough, nasal congestion, and low-grade fever. He is drinking well, has normal urine output, and is playful in the exam room. His temperature is 37.9°C, oxygen saturation is 99% on room air, respiratory rate is normal for age, and lung exam is clear without wheezing, crackles, retractions, or focal findings. His parent asks whether he needs “blood work or a chest x-ray to make sure it is not pneumonia.” Which response best reflects high-value care?
Read DetailsA 10-month-old uncircumcised male presents with fever to 39….
A 10-month-old uncircumcised male presents with fever to 39.3°C for 24 hours. He is well appearing, has no cough, rhinorrhea, vomiting, diarrhea, or rash, and exam does not reveal a clear source of fever. He has no prior history of UTI. Using a pediatric UTI prediction tool such as UTICalc, which clinical decision is most appropriate? UTICalc (Clinical Prediction Tool): https://uticalc.pitt.edu/
Read DetailsA 10-year-old boy presents with tea-colored urine and mild f…
A 10-year-old boy presents with tea-colored urine and mild facial swelling. BP is above the 95th percentile for age, sex, and height. UA shows 3+ blood, 2+ protein, and RBC casts. Nitrites and leukocyte esterase are negative.
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