Mad-about-pediatriccardiology

status asthmaticus : severe asthma unresponsive to  inhaled beta 2 agonists oral or intra venous steroids oxygen bronchospasms, airway constriction, M3 receptors stimulation , tachykinin secretion ---> leads to expiration becoming an active process End expiratory volume increases  Diaphragmmatic flattening from hyperinflation causes additional mechanical disadvantages FEV and FVC are decreased, FRC is increased. pulsus paradoxus : fall in SBP with inspiration - neg intrathoracic pressure, ideally the BP should fall.  leukocytosis ---> infection/ demargination hypokalemia ---> to be expected given continuous beta agonists hypomagnesemia : should be corrected --> has better prognosis all children with first time wheezing and severe status asthmaticus require a chest x ray inhaled beta agonists may nullify the compensatory pulmonary vasocontstriction response and worsen arterial hypoxemia, so O2 must be a part of all asthma treatment

Based on GISP data, CDC recommends combination therapy with ceftriaxone 250 mg intramuscularly and either azithromycin 1 g orally as a single dose or doxycycline 100 mg orally twice daily for 7 days as the most reliably effective treatment for uncomplicated gonorrhea. CDC no longer recommends cefixime at any dose as a first-line regimen for treatment of gonococcal infections. If cefixime is used as an alternative agent, then the patient should return in 1 week for a test-of-cure at the site of infection Link to website with the above recommendations

A 2 yo presents to the clinic with R sided ear pain, discharge and fever for the last 2-3days. When she woke up this morning her mother noticed that the skin around the R ear had turned red , with swelling behind the R ear as though the ear had been pushed forward .  She frequently gets ear infection and her last ear infection was last month when she was placed on amoxicillin for 10days. Mom denies a ny changes in her mental status , she has a poor appetite but had been drinking well and has had a good urine output. On taking a social history mom mentions that dad smokes inside the house and sometimes she puts her to sleep with a bottle of milk in her mouth. 1. What is your diagnosis? 2. Is imaging warranted in this scenario? 3. Why is the social history important in this case? 4. What is your choice of antibiotics ? Definition : - infection of the mastoid air cells - clinically characterized by a) protrusion of the pinna b) erythema/ tenderness over the mastoid p

You are seeing a 6month old baby girl for a well child check. The mother mentions that the baby was recently seen at the ER and was diagnosed with a right ear infection  2 weeks back. She was started on amoxicillin and completed the course 2-3 days back. Around the same time mom notes that the baby was having runny stools when she was using pedialyte and having bowel movements  almost 7-8 times / day. When you examine the baby you note she has an erythematous rash involving her diaper area which extends into her skin folds, you also notice that there are smaller satellite lesions adjacent to the main rash. The baby gets really fussy as you examine the diaper site, but easily consoles once you bundle her up. You explain to mom what you think the rash is , start her on nystatin cream, update her shots, give anticipatory guidance and discharge them home. 1. Looking at the rash in the picture below what is the probable etiology? How do you differentiate it with other causes? 2. What