5YR0CHILD0
20DAYS0DIARHEA,0VOMIT
PE=0SIGNS0OF0DEHYDRATION=0DRY0MUCOSA
BUT
NO0LETHARGY,0VSS
TX0OUTPATIENT?0-0ans✔ORAL0REHYDRATION=0
essentially0as0effective0as0intravenous0rehydration0for0dehydrated0children
===
WRONG0ANS=0ORDER0LABS/BMP
Juvenile0Arthritis
WHAT0JOINTS0ARE0MOST0VULNERABLE0TO0BONY0EROSION0-
0ans✔WRIST0AND0HIP0JOINTS
JUVENILE0ARTHRITIS
WHEN0SHOULD0UVEITIS0BE0SUSPECTED0AND0HOW0DOES0IT0PRESENT0-
0ans✔IF0ANA0HIGH=0SUSPECT0UVEITIS=0REFER0TO0OPTHO
UVEITIS=0USUALLY0ASYMPTOMATIC0IN0PT0WITH
JUVENILE0ARTHRITIS
===
TX=0NSAID0TO0REDUCE0INFLAMMATION
=
CAN0ALSO0USE0DMARD
YOU0SUSPECT0FAILURE0TO0THRIVE0IN0INFANT0WHO0LOST0A0LOT0OF0WEIGHT
WHAT0LABS0SHOULD0YOU0ORDER0-0ans✔TRICKY!
=
, Most0infants0with0failure0to0thrive0do0NOT0need0laboratory0evaluation==MOST0KIDS0H
AVE0NORMAL0LABS
=
only0evaluation0required0is0a0physical0examination0and0a0thorough0history,0including0di
etary,0feeding,0past0medical,0social,0and0family0histories.
CAUSES0FOR0FAILURE0TO0THRIVE0IN0A0KID0-0ans✔inadequate0caloric0intake,
0inadequate0absorption,
0increased0metabolism,0
or0defective0utilization.
==
TX0OF0FAILURE0TO0THRIVE
=
0additional0calories0in0their0diet0for0catch-up0growth.
=
0Infants0who0are0breastfed0may0need0to0be0fed0more0often,0or0may0require0suppleme
ntal0formula.
=
0Children0who0do0not0respond0to0dietary0or0feeding0modifications0should0have0a0labor
atory0evaluation0for0other0underlying0medical0conditions.
a05-year-old0male0has0had0
three0episodes0of0muteness0
=
accompanied0by0drooling0and0what0he0describes0as0a0"funny0taste"0in0his0mouth.
0The0episodes0all0occurred0
when0he0first0woke0up0in0the0morning,0
lasted03-50minutes,0and0
were0NOT0associated0with0a0loss0of0consciousness0or0postictal0state.
tow0-0ans✔BENIGN0FOCAL0EPILEPSY
=
AUTOSOMAL0DOMINANT0SO0USUALLY0A0PARENT0HAS0IT0TOO
FOCAL=0LAST0FEW0MINS
AND0SX0USUALLY0INVOLVE0MOUTH
=
DROOLING,0CAN'T0TALK0ETC
KIDS0WITH0COW0MILK0SENSITIVITY0LIKELY0ALSO0HAVE0-
0ans✔SENSITIVITY0TO0GOAT0AND0SHEEP0MILK