Clinical reasoning
Clinical teaching and practical ideas for your next study session.
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.
When a 28-Week Preterm Infant Needs More Oxygen: Is the PDA Really Driving the Deterioration?
At 21 days, a 28-week infant with rising oxygen needs, a continuous murmur, and pulmonary congestion may have a hemodynamically important PDA—but the murmur is not the diagnosis. This case discussion shows how to separate ductal pulmonary overcirculation from sepsis, evolving lung disease, and pulmonary hypertension, then use echocardiography together with the clinical picture to judge whether closure is likely to help.
SSRI Activation in Children and Teens: The Board-Ready Distinction From Mania
A three-day onset after starting an SSRI is a pattern clue, not a diagnosis by itself. Learn to distinguish activation from mania, serotonin toxicity, and akathisia, then revise the decision with retrieval practice.