INDEX OF SUSPICION

1992 ◽  
Vol 13 (11) ◽  
pp. 435-437
Author(s):  
Summer Smith ◽  
John L. Green ◽  
Susan K Lynch ◽  
Mark J. Polak
Keyword(s):  
Early Diagnosis ◽  
Physical Exertion ◽  
Tanner Stage ◽  
Pubic Hair ◽  
Acting Out ◽  
History Of ◽  
Prolonged Fatigue ◽  
Axillary Hair ◽  
Case Presentations ◽  
Diagnosed Diabetes

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 17-year-old boy is admitted to the hospital for evaluation and management of recently diagnosed diabetes mellitus. His mother expresses concern about his acting-out behavior and about frequent difficulties in drinking from a glass due to tremors. On examination he is found to be 68.5 inches tall, and he has a mild scoliosis. Evaluation of sexual development reveals axillary hair at Tanner stage III, pubic hair at stage V, penile length of 8 cm, left testicular volume of 3.0 x 1.8 cm, and an undescended right testicle. No breast tissue is palpable. Case 2 Presentation A 16-year-old girl is seen at your office with a history of prolonged fatigue and weakness. She has missed school frequently over the past 4 to 5 months, having had many vague complaints of "no energy," headaches, sore throats, aching knees, and the feeling that she will almost "pass out" if she does gymnastics or physical exertion of any kind.

INDEX OF SUSPICION

1994 ◽  
Vol 15 (1) ◽  
pp. 39-41
Author(s):  
Dennis J. McCarthy ◽  
Juan J. Jiménez Garcia ◽  
Holly Swanson
Keyword(s):  
Early Diagnosis ◽  
Stage Iv ◽  
External Genitalia ◽  
Tanner Stage ◽  
Breast Development ◽  
Upper Respiratory Infection ◽  
History Of ◽  
Upper Respiratory ◽  
Axillary Hair ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation As you finish examining a 14-year, 11-month-old girl for an upper respiratory infection, she asks when she might expect to stop growing. When told that most girls stop growing after menarche, she explains that she has never had a menstrual period. On examination, her height is 69 1/2 in (above the 95th percentile) and her weight is 119 lb (50th percentile). Her breast development is at Tanner stage IV, and she says that her breasts have remained at their present state of development for at least 3 years. She lacks both pubic and axillary hair. Her external genitalia are normal, as is the remainder of her physical examination. Case 2 Presentation A 9-year-old girl is brought to your office having a 1-week history of bilateral neck swelling.

INDEX OF SUSPICION

1994 ◽  
Vol 15 (12) ◽  
pp. 495-497
Author(s):  
Elliott M. Friedman ◽  
Alexandre T. Rotta ◽  
Vincent J. Menna
Keyword(s):  
Urinary Tract Infection ◽  
Early Diagnosis ◽  
Acute Urinary Retention ◽  
Positive Culture ◽  
Tanner Stage ◽  
Pubic Hair ◽  
The Past ◽  
Hair Development ◽  
Case Presentations ◽  
Similar Episode

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 13-year-old girl comes to you because it is so painful for her to urinate that she has developed acute urinary retention. Over the past 6 months she has had recurrent mild abdominal cramps; exactly 1 month ago she experienced a similar episode of dysuria. At that time she was able to urinate and was diagnosed by positive culture as having a urinary tract infection, for which she was treated. While preparing to catheterize her, you notice that this young woman is Tanner stage 5 in breast and pubic hair development, yet she states that she has never had a menstrual period. Her mother recalls her own menarche at age 11 years. Observations during the procedure allow you to determine the underlying cause of her problems.

INDEX OF SUSPICION

1995 ◽  
Vol 16 (3) ◽  
pp. 117-119
Author(s):  
Randy Cron ◽  
Laurette Ho ◽  
Bradley Bradford
Keyword(s):  
Early Diagnosis ◽  
External Genitalia ◽  
Low Grade ◽  
Palpable Mass ◽  
Pelvic Ultrasonography ◽  
Distended Bladder ◽  
Focus Of Infection ◽  
History Of ◽  
Case Presentations ◽  
Free Area

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A previously healthy 6-month-old girl is seen at the office for evaluation of fussiness and infrequent urination. The child has not voided in the past 9 hours despite her usual fluid intake. She is afebrile, with no focus of infection found on careful physical examination. A palpable mass is felt in the suprapubic area. Her external genitalia are normal. Renal and pelvic ultrasonography reveal an echo-free area superior to a normal lower renal ureteral segment on the left side, with a circular echo free area at the lower end of the ureter extending into and taking up about one quarter of the space within a distended bladder. Case 2 Presentation A 4-year-old boy is seen in your office with a 4-day history of sore throat and low-grade fever.

INDEX OF SUSPICION

1994 ◽  
Vol 15 (5) ◽  
pp. 201-203
Author(s):  
Mary D. Dvorak ◽  
Britta Mazur ◽  
A. George Pascual
Keyword(s):  
Early Diagnosis ◽  
Physical Examination ◽  
General Pediatrician ◽  
History Of ◽  
Night Awakening ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 6-day-old girl is brought into the clinic having a 12-hour history of fever to 101°F(38.3°C), irritability, and refusal to breastfeed. The child's mother is a bright, articulate woman who is very concerned about providing the best for this baby, her first, and is dedicated to breastfeeding. She notes that the child previously had been "a very good baby" - quiet, pleasant, and nondisruptive. Since birth, the child has slept for much of the day and night, awakening every 5 to 7 hours to feed. The baby usually wets her diapers after each feeding. However, her mother says that the last wet diaper was noted 6 hours ago, and it was barely wet. Upon physical examination, the child appears quiet but awake.

INDEX OF SUSPICION

1996 ◽  
Vol 17 (8) ◽  
pp. 291-294
Author(s):  
J. Peter Harris ◽  
Carol J. Buzzard ◽  
Liliana D. Gutierrez ◽  
Franz E. Babl ◽  
Susan K Ratzan
Keyword(s):  
Early Diagnosis ◽  
Good Health ◽  
Left Shoulder ◽  
High School Senior ◽  
Left Chest ◽  
School Senior ◽  
History Of ◽  
Female High School ◽  
Case Presentations ◽  
The Right

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation While driving to work, a 17-year-old female high school senior who has been in good health has an abrupt syncopal episode resulting in a headon collision at 40 miles per hour. She is alert and oriented right after the accident, but complains of sternal pain as well as pain in her left chest, left shoulder, and the right side of her jaw. Evaluation in the emergency department reveals slight tachypnea of 26 breaths/min, blood pressure of 90/60 mm Hg, a midsternal abrasion, a left pneumothorax, and nondisplaced fractures of the left clavicle and right mandible. Results of her neurologic examination, including mental status, are normal. She denies the use of any medication, street drugs, or alcohol, but she does report a 9-month history of brief spells of lightheadedness, diaphoresis, nausea, and visual blackouts, with one previous episode proceeding to complete syncope.

INDEX OF SUSPICION

1993 ◽  
Vol 14 (4) ◽  
pp. 155-157
Author(s):  
Juan A. Rivera ◽  
Bruce Taubman ◽  
Christine M. Walsh-Kelly
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Cholesterol Level ◽  
Urine Culture ◽  
Blood Chemistry ◽  
Recent History ◽  
History Of ◽  
Normal Urine ◽  
Case Presentations ◽  
Soft Stool

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 12-year-old girl is brought to you by her grandmother with a variety of complaints. The child has been overweight all of her life, and she tends to be constipated. She describes recurrent, colicky mid-abdominal pain after eating fatty meals and has had recurrent bouts of vomiting associated with cough and hiccups dating back to her infancy. There is no recent history of fever, asthma, or jaundice. On examination, the girl is obese, weighing 105 kg (231 lb). Chest and abdominal examinations are normal, with no masses or organomegaly. No focal tenderness is demonstrated. Formed soft stool is noted on rectal examination; the stool is hemocultnegative. Urinalysis is normal; urine culture is negative. The results of screening blood chemistry tests are normal except for a cholesterol level of 267 mg/dL and triglycerides of 280 mg/dL.

INDEX OF SUSPICION

1992 ◽  
Vol 13 (10) ◽  
pp. 391-393
Author(s):  
Geeta Berera ◽  
Robert H. Dixon ◽  
Willaim J. Koenig
Keyword(s):  
Weight Gain ◽  
Early Diagnosis ◽  
Nasal Congestion ◽  
Normal Serum ◽  
Past Medical History ◽  
Recurrent Vomiting ◽  
History Of ◽  
Case Presentations ◽  
Poor Weight Gain ◽  
Normal Serum Sodium

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations with discussions. Case 1 Presentation A 24-mo-old boy is seen with a 2-d history of cough and fever. His past medical history includes recurrent vomiting and poor weight gain since 3 mo of age, and he has been hospitalized five times for dehydration. The child sat independently at 7 mo of age but is not yet walking. On examination, he appears to be small and thin and is irritable. His temperature is 39.5°C(103.1°F), pulse is 150 beats/mm, and respiratory rate is 35 breaths/mm. The child's height, weight, and head circumference are all below the 5th percentile, but proportional. Except for nasal congestion and mild dehydration, the remainder of his examination is normal. Serum sodium is 140 mEq/L, potassium 3.5 mEq/L, chloride 117 mEq/L, and bicarbonate 11 mEq/L.

INDEX OF SUSPICION

1993 ◽  
Vol 14 (3) ◽  
pp. 117-119
Author(s):  
Vincent J. Menna ◽  
Summer Smith ◽  
Gregory S. Liptak
Keyword(s):  
Early Diagnosis ◽  
Blood Count ◽  
Complete Blood Count ◽  
Hip Pain ◽  
Physical Finding ◽  
The Past ◽  
History Of ◽  
Gag Reflex ◽  
Case Presentations ◽  
Breast Fed

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 2-month-old breast-fed boy is brought to the office with a 2-day history of constipation, poor feeding, lethargy, wheezing, and a temperature of 101°F (38.3°C). In the office his temperature is recorded at 98.8°F (37.1°C) rectally. The infant does not appear lethargic, and the only significant physical finding is tearing of the left eye. Because of the history of fever, a complete blood count is obtained, which is normal. The infant is discharged home with a diagnosis of conjunctivitis and possible viremia. He returns within 48 hours and is found to be hypotonic with a poor gag reflex, weak suck, and weak cry. Despite his normal temperature a septic evaluation is initiated. Case 2 Presentation A 17-year-old boy complains of bilateral hip pain that has bothered him for the past year.

INDEX OF SUSPICION

1992 ◽  
Vol 13 (4) ◽  
pp. 157-159
Author(s):  
Daniel D. Chapman ◽  
Marie C. McCormick
Keyword(s):  
Early Diagnosis ◽  
Left Knee ◽  
Perianal Area ◽  
The Past ◽  
Supervised Exercise ◽  
Reduction Program ◽  
Calorie Diet ◽  
History Of ◽  
Ear Infections ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A prepubertal 12-year-old boy who is obese (192 lbs, 68 in) is seen in the office for pain in the anterior and medial aspect of the left knee. The knee is not tender to palpation and has a range of motion equal to the normal right knee. He is in a weight-reduction program consisting of an 1800-calorie diet and supervised exercise four times per week. No history of trauma is elicited. Case 2 Presentation During the past 2 months, you have seen an 8-month-old boy twice for ear infections. At the last visit, 3 weeks ago, he also had a rash over his buttocks and in the perianal area that you treated with zinc oxide cream.

INDEX OF SUSPICION

1994 ◽  
Vol 15 (7) ◽  
pp. 289-291
Author(s):  
John C. Leopold ◽  
Andrew P. Sirotnak ◽  
Joseph Ryan ◽  
Vincent J. Menna
Keyword(s):  
Emergency Department ◽  
Early Diagnosis ◽  
Good Health ◽  
Burning Sensation ◽  
Periorbital Edema ◽  
Pediatric Clinic ◽  
General Pediatrician ◽  
The Family ◽  
History Of ◽  
Case Presentations

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A 13-year-old boy who has been in good health previously comes to the pediatric clinic with a history of a pruritic red rash that comes and goes for several hours after he has been swimming. This rash has been a problem for the last 5 days. Two days ago, after swimming, he developed a diffuse rash together with periorbital edema and a burning sensation on his back. He suddenly became lightheaded and collapsed into his mother's arms, losing consciousness briefly. By the time he arrived at the emergency department, the rash was gone and his examination was normal. No treatment was prescribed. Yesterday, while washing the family car with cold soapy water, his right arm and hand swelled and turned solidly red in a "glove" distribution.

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