Pediatric Clinical Cases Diagnoses

Pediatric Clinical Cases and Diagnoses
Clinical Case 1:
You are a pediatrician. At the reception, the child is a child of 7 months. On examination: the child is
restless, the temperature is 37.8°C, cough. Breathing is noisy, wheezing, wheezing can be heard in
the distance. It is necessary, after obtaining the consent of legal representatives for the examination,
to conduct a physical examination of the child and assess the symptoms characterizing the state of
the respiratory system.
Diagnosis: Bronchiolitis
Signs: Noisy breathing, wheezing, fever, cough
Laboratory Methods: Complete Blood Count (CBC), Chest X-ray
Instrumental Methods: Pulse oximetry
Treatment: Supportive care, hydration, nebulized bronchodilators, hospitalization if severe
Clinical Case 2:
The patient is a boy 10 months old. Complaints of pronounced pallor of the skin and mucous
membranes. The mother reported that the child gets tired quickly, is irritable, inactive, and noted a
loss of appetite. Upon further questioning, it was possible to establish that the child's diet is
monotonous: milk porridge twice a day, cookies with whole cow's milk or kefir. The mother prefers
not to give fruits, vegetables and meat, for fear of digestive disorders. The child practically does not
receive ready-made mixtures for 3 months due to their high cost. On examination: the child's
condition is satisfactory, pronounced pallor of the skin and mucous membranes, peripheral lymph
nodes are not enlarged. During auscultation of the heart, systolic murmur is heard. The abdomen is
soft, the liver protrudes 2 cm from under the edge of the costal arch. It is known from the anamnesis
that the child was born full-term, on mixed feeding from 1 month, he did not receive additional iron
preparations. A general blood test was performed, the HB content was 90 g/l. A stool with a
tendency to constipation.
Diagnosis: Iron Deficiency Anemia
Signs: Pallor, fatigue, irritability, systolic murmur
Laboratory Methods: Complete Blood Count (CBC), Serum Ferritin
Instrumental Methods: None specifically needed for diagnosis
Treatment: Iron supplementation, dietary counseling
Clinical Case 3:
The boy, 6 months old, was hospitalized in the Department of Allergology and Immunology of the
children's city Clinical Hospital with complaints of skin rashes and itching, constipation upon
admission. Anamnesis of life: a child from the first normal pregnancy, 1 physiological birth. I
screamed right away, The APGAR score is 8 points. Birth weight - 3000 g, length - 50 cm. It was
applied to the chest on the first day, Breastfed. Anamnesis of the disease: from 3 months of life,
when the mother included confectionery products (biscuits, shortbread cookies, chocolate) in her
diet, the child's condition worsened: he became irritable, moody, sleep worsened, areas of dryness
and hyperemia appeared on the skin.
Diagnosis: Atopic Dermatitis
Signs: Skin rashes, itching, family history of atopy
Laboratory Methods: Serum IgE levels, Skin prick tests
Instrumental Methods: None needed specifically for diagnosis

Treatment: Emollients, topical corticosteroids, dietary modifications
Clinical Case 4:
At the reception, a mother with a child, a girl of 5 months. Restless, sweats heavily, shudders in his
sleep. The condition is of moderate severity, moody. Weight 7700, height 60 cm. The skin is
moderately moist, clean from rashes. The head is hydrocephalic. The back of the head is flattened.
Large fontanelle 3x3 cm, softened edges. Pronounced frontal tubercles. The lower opening of the
chest unfolds, Harrison's furrow is determined, and the "rosary" is felt. The boundaries of the heart:
on the right - along the right parasternal line, on the left - 1 cm outward from the left middle clavicular
line. The heart rate is 130 beats per minute. The tones of the heart are clear and pure. Children's
breathing is in the lungs, there are no wheezing. The abdomen is flattened, soft, and there is a
divergence of the rectus abdominis muscles. The liver protrudes from under the edge of the costal
arch by 2 cm, the spleen by 1 cm. A stool with a tendency to constipation. He's sleeping freely.
Diagnosis: Rickets
Signs: Sweating, irritability, delayed motor skills, skeletal deformities (Harrison's groove, "rosary",
frontal bossing)
Laboratory Methods: Serum calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D
Instrumental Methods: Wrist X-ray showing metaphyseal cupping and fraying
Treatment: Vitamin D supplementation, calcium supplementation, dietary counseling
Clinical Case 5:
The girl, 1 year old, was admitted on the first day of the disease. In the morning, the body
temperature rose to 37.4°C, a transparent discharge from the nose appeared, a dry cough, by the
evening the cough became barking, hoarseness of voice appeared, noisy breathing. Upon
admission, the condition is severe, t 38°C, the girl is sluggish, pale, cyanosis of the nasolabial
triangle is pronounced. The voice is hoarse, the cough is barking. Stenotic breathing is pronounced
with the retraction of all the pliable places of the chest. The pulse is 148 per minute.
Diagnosis: Acute Laryngotracheobronchitis (Croup)
Signs: Barking cough, hoarseness, noisy breathing, retractions, cyanosis
Laboratory Methods: CBC to check for infection
Instrumental Methods: Neck X-ray (steeple sign)
Treatment: Humidified air, nebulized epinephrine, corticosteroids, hospitalization if severe
Clinical Case 6:
A boy of 1 month old. He entered the department at the age of 1 month with complaints from his
mother about poor weight gain, anxiety, poor appetite, regurgitation. Anamnesis data: a child from
the 1st pregnancy, which occurred with toxicosis throughout pregnancy, from a mother suffering
from congenital heart disease. During pregnancy, due to nausea, the mother ate monotonously with
insufficient protein in her food. Delivery on time. Body weight at birth is 2600 g, body length is 49
cm. I screamed right away. He has been on mixed feeding since the age of 2 weeks, and has
gained 500g in weight in 1 month. Upon examination by a neurologist, the diagnosis was made:
posthypoxic encephalopathy.
Diagnosis: Failure to Thrive, Posthypoxic Encephalopathy
Signs: Poor weight gain, regurgitation, anxiety, poor appetite
Laboratory Methods: CBC, metabolic panel
Instrumental Methods: Brain ultrasound, MRI if indicated

Treatment: Nutritional support, addressing underlying causes, developmental follow-up

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Pediatric Clinical Cases and Diagnoses

the respiratory system.

Signs: Noisy breathing, wheezing, fever, cough

Laboratory Methods: Complete Blood Count (CBC), Chest X-ray

Instrumental Methods: Pulse oximetry

Treatment: Supportive care, hydration, nebulized bronchodilators, hospitalization if severe

Diagnosis: Iron Deficiency Anemia

Signs: Pallor, fatigue, irritability, systolic murmur

Laboratory Methods: Complete Blood Count (CBC), Serum Ferritin

Instrumental Methods: None specifically needed for diagnosis

Treatment: Iron supplementation, dietary counseling

and hyperemia appeared on the skin.

Diagnosis: Atopic Dermatitis

Signs: Skin rashes, itching, family history of atopy

Laboratory Methods: Serum IgE levels, Skin prick tests

Instrumental Methods: None needed specifically for diagnosis

Laboratory Methods: Serum calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D

Instrumental Methods: Wrist X-ray showing metaphyseal cupping and fraying

Treatment: Vitamin D supplementation, calcium supplementation, dietary counseling

Diagnosis: Acute Laryngotracheobronchitis (Croup)

Signs: Barking cough, hoarseness, noisy breathing, retractions, cyanosis

Laboratory Methods: CBC to check for infection

Instrumental Methods: Neck X-ray (steeple sign)

Treatment: Humidified air, nebulized epinephrine, corticosteroids, hospitalization if severe

Diagnosis: Failure to Thrive, Posthypoxic Encephalopathy

Signs: Poor weight gain, regurgitation, anxiety, poor appetite

Laboratory Methods: CBC, metabolic panel

Instrumental Methods: Brain ultrasound, MRI if indicated

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