A 14-month-old child presents for his first well-child check…
A 14-month-old child presents for his first well-child check. He was recently adopted from a Romanian orphanage. His parents are concerned that he appears small compared to other children his age. His weight, height, and head circumference are all < fifth percentile. He eats very well but has not gained weight since the adoption last month. He urinates several times each day and has four loose, greasy stools daily. Review of systems is also significant for a mild chronic cough. Blood and stool studies are sent. A chest film reveals mild bilateral bronchiectasis. What is the most likely cause of the child’s poor weight gain?
Read DetailsA 5-year-old patient presents for their annual well-child ex…
A 5-year-old patient presents for their annual well-child exam. History reveals that the patient snores loudly most nights of the week. You also learn the patient is a very sound sleeper, is a mouth breather, tends to be hyperactive at school and reports headaches in the evening. Which parts of the history indicate a possible diagnosis of obstructive sleep apnea?
Read DetailsA 6-year-old girl presents to clinic after her teacher notic…
A 6-year-old girl presents to clinic after her teacher notices episodes of ‘spacing out’. The episodes typically last about 10 seconds and happen multiple times over the course of the school day. During these episodes, the girl becomes still and does not respond to attempts at engagement. There are no rhythmic movements noted and no loss of tone. After the episode is over, the girl resumes previous activity. The girl’s vital signs and physical exam are normal. A staring spell is elicited after having the girl blow a pinwheel in clinic. What is the most likely diagnosis?
Read DetailsA 15-year-old boy presents to the clinic with hypopigmented…
A 15-year-old boy presents to the clinic with hypopigmented macules on the bilateral upper extremities that have become apparent over the last several months. On examination, the lesions are non-scaly and well demarcated without evidence of inflammation. They range in size from several millimeters in diameter to several centimeters. Under Wood’s lamp examination, the lesions emit a sharply demarcated blue-white fluorescence. Which of the following is the most appropriate management?
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