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Pediatric Management and Diagnostic Dilemma Tool
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Hot Seat #162: A Patient with Inadequate Imaging

HPI: 16-year-old male with no pertinent past medical history presents for medical clearance with police.  Earlier today he was in a physical altercation and was subsequently arrested.  During the altercation, he notes that he was punched multiple times in the face, and ultimately thrown to the ground. He currently reports pain in his jaw and […]

Hot Seat #157: 10 day old with elbow swelling

CC: 10 day old girl with elbow swelling HPI: 10 day old ex FT girl presenting with left elbow swelling and decreased movement of left arm. Parents report that in the middle of the night, they noticed she was not moving her left arm the same way she was her right. Waking every 1-3 hours […]

Hot Seat #176: 15-year-old with syncope

Tim Carr, MD, Children’s National Medical Center HPI A 15-year-old boy with history of epidural hematoma presented following a syncopal episode. Patient states he was cooking breakfast about 1 hour prior to arrival, inhaled in some smoke from the bacon, felt a wave of nausea, felt faint and passed out. The episode was witnessed and […]

Hot Seat #175: 16-year-old with vertigo

Malek Mazzawi, MD, Children’s National Medical Center HPI 16-year-old male with anxiety presents with 1 day of dizziness and a sensation of the room spinning. It began when he laid down in bed the night prior and now he has difficulty ambulating due to unsteadiness. Dizziness is constant with mild headache, no ear pain. Some […]

Hot Seat #174: Denouement

The case: A 4 year old with febrile seizures with persistent fevers and managing parental expectations around the workup. Here’s how you answered the questions: The interpretation of an equivocal urinalysis is a common dilemma in pediatric emergency medicine. In this case, a well appearing child presents with a fever without a focus, complicated by […]

Hot Seat #174: 4 year old with febrile seizure

Rachel Hatcliffe, MD, Children’s National Medical Center HPI: 4.5 year old female with history of prior febrile seizure presents to the emergency room after a 5-10 minute seizure in the setting of one day of fever. Earlier this morning she had one episode of NBNB emesis and was found to have fever to 39.3C. Her […]

Hot Seat #173: 5yo with fever and rash

Malek Mazzawi, MD, Children’s National Medical Center HPI: Outside hospital calls requesting transfer of a 5-year-old previously healthy girl with fever and rash for 7 days. She was diagnosed with roseola 5 days prior at urgent care then started having worsening headache, somnolence and decreased PO. She developed a diffuse, non-pruritic, erythematous rash on her […]