pedirex360@gmail.com It started with something trivial. A persistent headache. Not severe. Not disabling. Just… there. The kind of symptom doctors ignore every day, because there are patients to see, charts to finish, calls to return. “Probably stress,” he told himself. He prescribed rest. To himself. But rest never came. And Weeks later, he found himself sitting … Read more
A previously well 6-year-old girl was brought to the emergency department after being found unusually lethargic with vomiting and abnormal breathing while staying with relatives. She had been reportedly healthy earlier in the day. There was no known history of trauma, fever, or chronic illness. On arrival, she appeared critically ill with a depressed mental … Read more
A 14-week-old male infant was brought to the emergency department with fever, cough, and progressive respiratory distress. Caregivers reported three days of rhinorrhea and nasal congestion followed by worsening cough and decreased feeding over the preceding 24 hours. During the last 10 hours, the infant developed post-tussive emesis, tactile fever, and increased work of breathing. … Read more
A 9-week-old female infant was brought to the emergency department with progressive lethargy, decreased oral intake, and increased work of breathing. Caregivers reported that she had been sleeping more than usual and appeared less interactive over several days. Feeding had become increasingly difficult, with diaphoresis and tachypnea during bottle feeds requiring frequent pauses. On arrival, … Read more
Q:1 A 4-year-old with severe pneumonia is intubated. Despite FiO₂ 1.0 and adequate ventilation (PaCO₂ 40 mmHg), PaO₂ remains 55 mmHg. Chest X-ray shows bilateral consolidation. What is the primary mechanism of hypoxemia? A. Alveolar hypoventilationB. Diffusion limitationC. Intrapulmonary shuntD. Increased dead spaceE. Low inspired oxygen fraction Answer: CExplanation:Refractory hypoxemia despite high FiO₂ indicates shunt … Read more
Q:1 An 8-year-old with septic shock is intubated and receiving norepinephrine. ScvO₂ is 82%, lactate is 5 mmol/L, and capillary refill is delayed. Echocardiography shows preserved systolic function. What is the most likely explanation for the elevated ScvO₂? A. Excess oxygen delivery relative to demandB. Impaired tissue oxygen extractionC. Severe anemiaD. High cardiac output with … Read more
SET 1: Q: 1 A term male becomes tachypneic 30 minutes after birth. Preductal SpO₂ is 96% and postductal is 86%. No murmur. Which physiologic change most directly explains the gradient? What is the single best explanation for the differential saturation? A. Decreased endogenous prostaglandin production causing PFO closure B. Increased pulmonary venous return promoting … Read more
Acute Fulminant Myocarditis Presenting as Cardiogenic Shock in a Previously Healthy Child A previously healthy 4-year-old male presented to the emergency department with 24 hours of fever (38.5°C), vomiting, and progressive lethargy. Vital signs showed tachycardia at 165 bpm, hypotension (78/42 mmHg), tachypnea (36 breaths/min), and oxygen saturation 94% on room air. Physical examination revealed … Read more
Constipation is one of the most common reasons parents bring their child to a pediatrician. It can cause significant discomfort, anxiety, and even behavior changes in children, yet it is often misunderstood. Many parents think constipation means “not passing stool every day.” In reality, constipation is more about how difficult or painful bowel movements are, … Read more
A 2-month-old infant is 8 hours post–VSD patch closure and PDA ligation. Temperature is 38.3°C, lactate is rising, and CVP is elevated. Temporary atrial and ventricular epicardial pacing wires are in place. The surface ECG (Lead II) and atrial electrogram (AEG) from pacing wires are shown above. Quiz QuestionWhat is the most likely rhythm diagnosis, … Read more