Pediatrics blog
Clinical teaching and practical ideas for your next study session.
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.
Positive TREC Newborn Screen: What to Do Before SCID Is Confirmed
An abnormal TREC result is not yet SCID, but waiting for the full diagnostic workup can expose an infant to preventable harm. Learn which precautions are immediate, which are conditional, and how to reason through the board-style management fork.
Infant Cardiac Output Is Heart-Rate Dependent—But Not Heart-Rate Only
A falling heart rate can mean recovery—or loss of compensation. Learn how to combine developmental cardiac physiology with perfusion, rhythm, and resuscitation context to interpret the change correctly.
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.
CoNS-Positive Blood Culture in a Child With a Central Line: Salvage or Remove?
A stable child with a single CoNS-positive culture needs paired source assessment before a line decision. Learn to distinguish contamination, intraluminal colonization, CLABSI surveillance, and true CRBSI, then match salvage or removal and treatment duration to culture clearance.
The Plethoric, Jaundiced Newborn: Hypoglycemia, Hyperviscosity, and Bilirubin Risk
A board-focused case discussion of early neonatal jaundice with hypoglycemia and polycythemia, emphasizing parallel stabilization, differential diagnosis, and escalation decisions.
Severe PPHN Echo Findings: A Board-Ready Reading Method
Learn to connect shunt direction, septal bowing, tricuspid regurgitation, and ventricular function when interpreting severe PPHN echocardiography questions.
Severe PPHN on Echocardiography: Read the Pressure Pattern
Severe persistent pulmonary hypertension of the newborn is best recognized as a linked pressure-and-flow pattern, not a single echocardiographic measurement. Learn how RV pressure, septal geometry, shunt direction, and ventricular function fit together.
The Febrile 6-Week-Old Who Looks Sick: Sepsis, Shock, and the Limits of “Low Risk”
A practical case discussion on recognizing shock in a febrile young infant, avoiding inappropriate low-risk pathways, and choosing empiric therapy when meningitis is possible.