Council on Medical Student Education in Pediatrics


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COMSEP Clinical Cases


  1. An eighteen-month-old boy is found in the garage holding a jar of paint thinner. The parents smell the chemical on his breath and on his clothing. He is acting normally. What would you instruct the parents to do?
  2. A two year-old child is found in the bathroom with an open bottle of liquid drain cleaner. She has a small area of bleeding on her lips. What is the most serious toxicity of this ingestion/exposure.
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  3. A two-year-old boy is brought to the Emergency Department in a coma after his mother found him limp and unresponsive in his room. What questions would you want to ask the mother to help learn why this patient might be unresponsive?
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  4. You receive a phone call from the mother of a 12 kg two year-old child who was found eating her mother's prenatal vitamins that contain iron. Each tablet contains 60 mg of elemental iron. She thinks he may have swallowed 16 tablets. What amount of elemental iron ingestion is potentially toxic for a child? What additional information do you need from the mother? What advice would you give the mother?
  5. After a fight with her boyfriend, an 80 kg. sixteen year-old takes thirty 500 mg acetaminophen tablets. She presents to the emergency department six hours later when she is feeling nauseated. What is the appropriate evaluation and management of this adolescent?
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  6. A three-year-old is brought to the Emergency Department because of weakness, diarrhea and drooling. He had been playing unsupervised in the garage. He is found to have pinpoint pupils and bradycardia. What is the most likely cause of these symptoms and how should the patient be treated?
  7. A three-year-old child is seen in the clinic because of irritability, decreased appetite and intermittent abdominal pain. He has developmental delay and a history of iron deficiency anemia. How would you evaluate and manage this child?
  8. The parents of a twelve-month-old girl bring her for a routine health care supervision visit. What anticipatory guidance would you give them to minimize the likelihood of an accidental poisoning occurring in the house?
  9. A two-year-old girl is brought to the Emergency Department after ingesting an unknown quantity and type of her grandmother's pills. What resources are available to help identify and treat the ingestion?
  10. During the winter, the parents of a seven year-old bring their son to your office because of headaches, fatigue, and nausea. Other family members have had similar complaints. What would you be concerned about?

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