A 2-year-old is brought to the clinic with a three-day history of fever, cough, and increased work of breathing. On physical examination, you note that he is breathing rapidly and shallowly, and you hear distinct grunting with each exhalation. These clinical findings are most typical of pathology affecting which part of the respiratory system?
An 8-year-old child is being managed in the intensive care unit for severe traumatic brain injury (TBI). His current mean arterial pressure is 75 mmHg and his intracranial pressure is 20 mmHg. The team is targeting an age-appropriate cerebral perfusion pressure. Which statement accurately reflects his current status?
The parents of a 3-year-old preverbal child are concerned after arriving at a high-altitude location for a family vacation. They report that their daughter has been extremely fussy, has not been eating well, and has refused to play for the past day. You suspect acute mountain sickness (AMS). What is the most appropriate diagnostic tool to aid in confirming this diagnosis in this child?
A 10-year-old child is undergoing an apnea test as part of a brain death evaluation. The test is stopped prematurely after 6 minutes because the patient becomes hypotensive. The arterial blood gas drawn just before stopping the test shows a PaCO2 of 52 mmHg with a pH of 7.28. What is the correct interpretation and necessary next step?
A 5-year-old is rescued from a lake after struggling in the water. He is now on the shore, awake, alert, and coughing but breathing on his own. Emergency medical services have been called. What is the most appropriate initial action to be taken by a bystander for this conscious drowning victim?
A 16-year-old boy experiences a syncopal episode without warning while actively playing in a basketball game. Which of the following is the most concerning potential diagnosis?
An 8-year-old boy is brought to the emergency department after sustaining a scald burn from hot soup. The affected area on his forearm is erythematous, has multiple intact, moist blisters, and is noted to be extremely painful to the touch. Based on these characteristics, how should this burn be classified?
A 14-year-old boy is admitted with septic shock and has a central venous catheter placed. Despite initial fluid resuscitation and initiation of a norepinephrine infusion, he remains tachycardic and poorly perfused. A central venous oxygen saturation (SvO2) is measured from the catheter and returns at 55%. What does this value most likely indicate?
A 2-year-old pulls a pot of boiling water off the stove, resulting in partial-thickness burns to his chest and abdomen. The burns are estimated to cover 12% of his total body surface area. According to the American Burn Association referral guidelines, what is the most appropriate disposition for this patient?
A 7-year-old with known type 1 diabetes is brought to the emergency department with altered mental status. He is breathing rapidly and deeply. The physical exam reveals no wheezing, retractions, or grunting. What is the primary mechanism driving this respiratory pattern?
