MedBugs: SAQ #581

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Case: Febrile Toddler

A 2-year-old male presents to your ED with a 5-day history of fever and cough.

1. List (3) abnormalities shown on the X-ray above. 3 marks

2. List (2) differential diagnoses for the above findings. 2 marks

Vital signs: Temp 40°C, HR 180 bpm, BP 85/40 mmHg, SaO2 87% on RA, RR 45/min, cap refill 3 seconds. Estimated weight 9 kg. Additional history: ex-32-weeker, lost to follow up, non-English speaking background, immunisations up to date.

3. List (4) treatments you would consider in this patient, including doses and/or endpoints. 4 marks

Venous blood gas: pH 7.3, PCO2 35 mmHg, PO2 68 mmHg, bicarbonate 17 mmol/L, Na 127 mmol/L, K 3.7 mmol/L, glucose 3.1 mmol/L.

4. Briefly state your interpretation of the blood gas findings. 3 marks

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Case: Febrile Toddler

1. List (3) abnormalities shown on the X-ray above. 3 marks

2. List (2) differential diagnoses for the above findings. 2 marks

3. List (4) treatments you would consider in this patient, including doses and/or endpoints. 4 marks

4. Briefly state your interpretation of the blood gas findings. 3 marks

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