Case Discussion
Clinical teaching and practical ideas for your next study session.
Pediatric Anaphylaxis: The Five-Minute Epinephrine Decision
When a child is still wheezing and hypotensive five minutes after IM epinephrine, repeat the dose and support circulation in parallel. Learn when to escalate further.
Pediatric Epiglottitis Extubation: Don’t Let the Cuff Leak Decide
For a child recovering from epiglottitis, a missing cuff leak is a risk signal—not an automatic veto. Weigh clinical recovery, breathing readiness, airway assessment, and a credible rescue plan.
Bronchiolitis With a New High Fever: When to Reopen the Pneumonia Differential
A new high fever and persistent focal lung findings should reopen—not settle—the pneumonia question in bronchiolitis. Learn when chest radiography can help and why an opacity alone should not trigger antibiotics.
Persistent Tachypnea in Pediatric Asthma: When Albuterol May Raise Lactate
When a child’s air entry and work of breathing improve but tachypnea persists, beta-agonist–associated lactate may be part of the picture. Learn how to reassess obstruction and perfusion without reflexively escalating bronchodilators.
Yellow Fever Before Nigeria: A Pediatric Timing Dilemma
Does the child need yellow-fever vaccination for entry, exposure prevention, or both—and can she receive an appropriately spaced primary dose in time before Nigeria travel after recent varicella? Compare entry guidance with vaccine spacing, protection timing, and the 10-day ICVP rule before deciding whether to delay travel.
A 2-Year-Old Missed the 12-Month Visits: Rebuild the Vaccine Plan Without Restarting
A toddler who missed several vaccine visits needs an antigen-by-antigen catch-up plan—not a reset. Learn which records matter, what may be due now, and which doses follow different age rules.
Central Precocious Puberty: Why Routine LH Checks Mislead
Routine LH checks can look pubertal despite effective suppression. Learn what to follow during GnRH-agonist treatment and when targeted testing is warranted.
After Testosterone for Delayed Puberty: Follow Testicular Growth
A short testosterone course can change voice, hair, and growth without proving the boy’s own pubertal axis has activated. Learn why testicular growth after treatment—not virilization alone—guides reassessment.
Infant Faltering Weight With Diarrhea: When Formula Dilution Isn’t the Whole Story
Diluted formula can explain inadequate calorie intake, but it should not end the workup when an infant also has persistent bulky stools or signs of nutrient deficiency.
Neonatal Hyperammonemia: How Acid–Base Clues Shape the Differential
In a sick newborn with hyperammonemia, ketonuria helps—but it is not the diagnosis. Learn how acid–base status, anion gap, glucose, and lactate shift the differential.
A Failed Neonatal Hyperoxia Test Does Not Diagnose CHD
A low PaO₂ after 100% oxygen can reflect cyanotic heart disease, PPHN, or severe lung disease. Learn why the hyperoxia test cannot settle the diagnosis—and what should happen next.
Pneumatosis in NEC: How to Decide When a Preterm Infant Needs Surgery
A preterm infant with pneumatosis, portal venous gas, bloody stool, and shock needs more than a Bell-stage label. This case discussion connects the mechanism of intramural gas to bedside escalation, clarifies when surgical consultation should become urgent, and avoids the traps of waiting for free air or blaming the feed.