Pediatric Quiz (February 2010)

Staphylococcus aureus is the likely organism to cause the condition mentioned. This is because Staphylococcus aureus is a common bacterium that can cause various infections in humans, including skin infections, pneumonia, and bloodstream infections. It is known to be a leading cause of skin and soft tissue infections, as well as certain types of pneumonia. Therefore, considering the information provided, Staphylococcus aureus is the most likely organism to cause the condition.

Myringotomy with tube insertion is the best way to treat Otitis Media with Effusion. This procedure involves making a small incision in the eardrum to drain fluid and then inserting a tiny tube to help ventilate the middle ear and prevent fluid buildup. This allows the ear to function properly and reduces the risk of recurrent infections. Tonsillectomy, adenoidectomy, and tympanostomy are not the most effective treatments for Otitis Media with Effusion.

The next appropriate step in this case would be to estimate the levels of Free T4, Antithyroglobulin Antibody, and Thyroid Peroxidase Antibody. This is because the girl has presented with Goitre and her TSH levels are high, indicating a potential thyroid disorder. Estimating these levels can help determine the underlying cause of the Goitre and guide further management. Referring the child to an endocrinologist may also be necessary, but the first step would be to conduct these tests for a more accurate diagnosis. Starting Levothyroxine or reassuring the parents and reassessing after 6 weeks may not be appropriate without further investigations.

Late hemorrhagic disease of newborn is a bleeding disorder that occurs in infants between 2 and 12 weeks of age. It is caused by vitamin K deficiency, which is necessary for blood clotting. Intramuscular vitamin K prophylaxis at birth is recommended to prevent this condition. The disease can lead to bleeding in various parts of the body, including the brain, but it is not specifically associated with cow-milk fed babies.

The child's symptoms of fever, coryza, and maculopapular erythmatous rashes that lasted for 48 hours and disappeared without pigmentation are consistent with Roseola infantum. Measles typically presents with a prodrome of fever, cough, coryza, and conjunctivitis followed by a maculopapular rash that lasts several days and may leave behind pigmentation. Fifth disease presents with a "slapped cheek" rash and can cause joint pain. Typhoid fever typically presents with fever, abdominal pain, and diarrhea. Therefore, the most likely clinical diagnosis in this case is Roseola infantum.

The correct answer is "Oseltamivir should be started along with symptomatic treatment." This statement is false because oseltamivir is not recommended for the treatment of mild cases of influenza, including those caused by H1N1. Symptomatic treatment, such as rest, fluids, and over-the-counter medications, is typically sufficient for managing mild cases of the flu.

Congenital hydrocoele is a condition where there is a collection of fluid in the scrotum of a male infant. It is typically non-painful and usually resolves on its own by the age of 2 years. Therefore, the statement "Causes painful swelling" is not true for congenital hydrocoele. The other statements are true, as congenital hydrocoele does not go away by age 2 years, it can come and go, and it is indeed a non-communicating hydrocoele.

Bacterial endocarditis is an infection of the inner lining of the heart chambers and heart valves. It occurs when bacteria from other parts of the body, such as the mouth or skin, enter the bloodstream and attach to damaged areas in the heart. While coarctation of the aorta, VSD, and PDA can all potentially lead to the development of bacterial endocarditis, ASD does not have the same risk. This is because ASD does not involve any structural abnormalities or damage to the heart valves, reducing the likelihood of bacterial attachment and infection.

The most probable diagnosis for this child's symptoms is sickle cell disease. Sickle cell disease is a genetic disorder that affects the red blood cells, causing them to become crescent-shaped and less able to carry oxygen. This can lead to various complications, including pain crises and joint pain. The child's history of recurrent joint pain at different joints is consistent with the joint manifestations commonly seen in sickle cell disease. Additionally, the initial presentation with fever and pain in the right shoulder could have been a vaso-occlusive crisis, a common complication of sickle cell disease.

Prednisolone is the treatment of choice in a Haemophilic with spontaneous hematuria because it is a corticosteroid that helps reduce inflammation and suppress the immune system. Spontaneous hematuria refers to the presence of blood in the urine without any apparent cause or injury. Prednisolone can help reduce the inflammation in the urinary tract and prevent further bleeding. It is important to note that Prednisolone should not be used in all cases of hemophilia, but specifically in cases of spontaneous hematuria.