Council on Medical Student Education in Pediatrics

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COMSEP Clinical Cases

THERAPEUTICS

  1. A three-year-old has acute otitis media. She is not allergic to any medications. Which if any antibiotics would you prescribe and why? What treatments could you offer this patient to alleviate the pain?
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  2. An eighteen-month-old has bilateral injected conjunctiva with purulent drainage. There are no other physical findings. How would you manage this patient?
  3. A four-year-old girl has urinary urgency and dysuria. A clean catch urine shows 50-100 white blood cells, 5-10 red blood cells, and positive nitrites and leukocyte esterase. How would you manage this child? If the urine culture was positive, what further evaluations would you do?
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  4. The mother of a one year-old girl with a fever of 39 C asks if she should give her child medicine for the fever. What other information should you gather from the mother? What is the appropriate dose of acetaminophen OR ibuprofen and how often should it be administered?
  5. A six year-old boy has been coughing particularly at night for 3 days. On physical examination he has diffuse wheezes. There is no history of reactive airway disease. Discuss your initial assessment and treatment?
  6. A thirteen-year-old has had a persistent cough without other complaints or findings for the past week. It is not interfering with sleep. How would you manage this child?
  7. A ten-year-old presents with a headache, nasal discharge and a mild cough. He is afebrile now and his examination is unremarkable. How would you manage this patient?
  8. A two-year-old presents with a recurrent pruritic rash on his arms and legs. He has patches of erythema with obvious excoriations on the extensor surfaces of his arms, legs, and also in the antecubital fossae. How would you treat this condition? What preventive measures may be helpful to prevent further flare-ups?
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  9. An eleven-year-old has a sore throat. She has fever and a headache. Her pharynx is red and there are petechiae on the soft palate. The rapid streptococcal test is positive. How would you treat this child? When can she return to school?
  10. A known asthmatic complains of worsening cough and wheezing, unresponsive to inhaled albuterol. How would you manage this patient?
  11. A ten-year-old swimmer complains of otalgia and ear discharge. His right external ear canal is filled with a purulent discharge. There is pain on touching the pinna and he won't allow you to inspect inside the ear. Discuss your diagnosis and initial treatment plan. What measures could prevent this from recurring?
  12. The mother of two young children asks which sunscreen and insect repellent to use on a camping trip. What advice would you give her? When and how often should she apply the products?

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