Paediatrics

A boy is born at 39 weeks weighing 2.5 kg to a woman with epilepsy who took a single antiepileptic drug throughout the pregnancy. He has a broad flat nasal brid…

Clinical rotations · niche

You are the intern in a newborn follow-up clinic. A 9-day-old boy has been recalled because his newborn bloodspot screening result shows a markedly raised thyro…

Pre-internship · middle twist

A 7-day-old breastfed girl is admitted with a two-day history of poor feeding and vomiting. She is deeply jaundiced, lethargic and hypothermic, with a liver edg…

Clinical rotations · niche

A boy born at 38 weeks is hypotonic and feeds slowly. Rapid chromosome testing has confirmed trisomy 21. He is pink in air with a normal respiratory rate, the p…

Pre-internship · middle twist

A term girl weighing 2.6 kg is examined before discharge. The backs of both hands and both feet are puffy and doughy, and there is loose redundant skin over the…

Clinical rotations · middle twist

The parents of a healthy 3-day-old boy ask you to arrange his circumcision before they go home. They give family and cultural reasons. His foreskin is normal fo…

Pre-internship · middle twist

A boy was born at term to a woman with chronic hepatitis B infection. He was given hepatitis B immunoglobulin and monovalent hepatitis B vaccine within twelve h…

Pre-internship · middle twist

At the six-week check, the mother of a healthy breastfed girl says she is so tired that for the second half of most nights she brings the baby into her own bed.…

Clinical rotations · common

A healthy boy is born at term after an uncomplicated pregnancy. His mother takes no regular medicines. She tells the midwife she does not want him to have any i…

Pre-internship · middle twist

A 4-week-old exclusively breastfed boy is brought to the emergency department because he is still yellow. He feeds hungrily and has gained 900 g since birth. Hi…

Pre-internship · middle twist

You examine a 2-day-old girl before discharge from the postnatal ward. She was born by caesarean section at 38 weeks for persistent breech presentation and is h…

Clinical rotations · common

A woman in preterm labour at 29 weeks is given betamethasone and transferred to a tertiary centre. Antenatal ultrasound and screening have all been normal and t…

Clinical rotations · common

A girl born at 36 weeks weighing 2050 g is three hours old and has fed twice at the breast. She becomes jittery with a weak high-pitched cry, and then has an ep…

Pre-internship · middle twist

A boy is born at 39 weeks weighing 4450 g to a woman whose gestational diabetes required insulin from 28 weeks. The birth was complicated by shoulder dystocia r…

Clinical rotations · common

A boy born at 38 weeks is 44 hours old on the postnatal ward. His mother attends a treatment program for a daily supervised dose of buprenorphine and reports no…

Pre-internship · middle twist

A girl born at 38 weeks weighs 2.2 kg and her head circumference is well below the third centile. Scattered purple-red spots over the trunk do not blanch, and t…

Clinical rotations · middle twist

A boy is born at 39 weeks after spontaneous labour. The membranes ruptured 26 hours before birth and his mother had a temperature of 38.4 degrees during labour;…

Pre-internship · middle twist

A five-week-old exclusively breastfed boy is brought to the general practitioner because he is still yellow. He was born at term weighing 3.4 kg and now weighs…

Clinical rotations · middle twist

A 32-year-old woman attends her general practitioner for the six-week postnatal check with her healthy son. She says she is coping, sleeping when he sleeps and…

Pre-internship · middle twist

A 29-year-old woman brings her six-week-old first baby to the general practice for his immunisations. Asked how she is, she says she has felt flat since about t…

Clinical rotations · common