Consultant for Pediatricians Vol 5 No 7

A male neonate was born at 39 weeks' gestation by vertex vaginal delivery with focal swelling of the head. Vacuum extraction and forceps were not necessary for delivery. The mother had no complications during labor. Apgar scores were 7 and 9 at 1 and 5 minutes, respectively. A cephalhematoma was suspected when the fluctuant parietal swelling did not transilluminate.

The mumps outbreak in Iowa and other midwestern states appears to be slowing. However, it is not yet contained. Are you prepared?

Staphylococcal pneumonia can be a rapidly progressive illness that is commonly associated with pneumothorax and pleural effusion. Affected patients require close monitoring. Consider staphylococcal infection in any infant with pneumonia whose health deteriorates clinically or radiographically.

A 17-year-old boy with no history of foot problems decided to try some new moves with his skateboard on a steep ramp. Midway down the ramp, he tumbled head over heels and landed with most of his weight on his plantar-flexed right foot.

Child Protective Services (CPS) has asked you to evaluate a 6-month-old girl with a genital mass. The goal is to determine whether the "weird lump in the baby's private area"--noted while the child's diapers were being changed in day care--was the result of sexual abuse.

Fourteen-year-old JT is worried. During health class last week, he learned about the different sexually transmitted infections as well as about testicular self-examination. While practicing his monthly testicular examination in the shower, he noticed that he had a number of small growths on his penis. On further questioning, JT insists that he has never been sexually active with another person.

A 12-year-old African American boy presented to the emergency department with a painless swelling on the left side of his head that had gradually progressed over a month. There was no history of pain, trauma, or fever. Findings from a review of all other systems were normal.

A 9-day-old boy was brought in for routine care. His mother had noticed these teeth at the child's birth. There were no other remarkable physical findings. Natal teeth occur in 1:700 to 1:6000 births, write Howard Fischer, MD, and Ahdi Amer, MD, of Children's Hospital of Michigan in Detroit. Such teeth are most often seen in the mandibular incisor area, often in pairs.

Pediatric ECGs are regularly performed for a variety of conditions, including chest pain, syncope, and suspected arrhythmia. Correct interpretation of ECGs can be challenging when technique is faulty or when the variability of normal values in children is not taken into account.

A 6-year-old girl with a nonproductive cough for 4 days and chest pain for 2 days was brought to the emergency department. According to the mother, the child had no fever or wheezing. She had no history of surgery, was not taking any medications, and had no contact with ill persons.

Medicine is at least as much art as science. Often things are not clear-cut, but rather appear in shades of gray. We offer the following list of terminology for those who don't mind thinking in terms of black or white.

Ten-year-old girl assessed because of limitation of neck motion. Born at term to non-consanguineous parents. No history of necktrauma. Family history andpast health unremarkable.