By Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph Raine, Joanna Walker

ISBN-10: 0340968753

ISBN-13: 9780340968758

The hot variation of this best-selling identify from the preferred a hundred situations sequence explores universal paediatric eventualities that would be encountered through the clinical pupil and junior general practitioner in the course of sensible education at the ward, within the emergency division, in outpatient clinics and in the neighborhood, and that are more likely to characteristic in qualifying examinations. The e-book covers a complete diversity of shows from cough to constipation, equipped via sub-specialty quarter for ease of reference. finished solutions spotlight key take domestic issues from every one case and supply functional recommendation on tips to care for the demanding situations that happen while working towards paediatric medication in any respect degrees.

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There is no hepatomegaly. Femoral pulses are palpable and his chest is clear. 62 m, PEFR range 320–570 L/min). On palpation there is no chest tenderness. INVESTIGATIONS His ECG and chest X-ray are both normal. Questions • What is the most likely diagnosis and the differential diagnosis? • What treatment would you suggest? 27 100 Cases in Paediatrics ANSWER 8 The most likely diagnosis in this case is idiopathic chest pain. This is one of the commonest causes of chest pain in children. Psychological chest pain, which may be a replication of the pain his grandfather used to have, and may be secondary to various stresses such as bullying, is a further possibility.

Severe Ebstein’s anomaly and obstructed total anomalous pulmonary venous drainage can produce early cyanosis, but these conditions are associated with significant respiratory distress. Persistent fetal circulation also results in cyanosis, usually with respiratory distress in the context of a newborn who has suffered a significant hypoxic, hypothermic or hypoglycaemic insult, who has pulmonary hypoplasia or sepsis, or sometimes for unknown reasons. Transposition of the great arteries accounts for up to 5 per cent of congenital heart disease and is the commonest cardiological cause of cyanosis in the newborn.

There are small bilateral pleural effusions. These features are consistent with the clinical diagnosis of pneumonia. The combination of clubbing and recurrent chest infections is strongly suggestive of cystic fibrosis (CF). This is the commonest cause of clubbing in children in the UK. Normal immunoglobulins exclude antibody deficiencies such as X-linked hypogammaglobulinaemia. Malabsorption (with bulky, offensive stools) is another common feature of CF. Cystic fibrosis is an autosomal recessive condition affecting 1 in 2500 children born in the UK.

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100 Cases in Paediatrics by Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph Raine, Joanna Walker

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