Pediatrics is easy

04/11/2026

28/10/2026

A 13-year-old boy is camping with his family.

While putting on boots, he feels an immediate sharp pain in his toe.

He pulls off the boot, turns it over, and shakes out a scorpion.

He is brought to the emergency department by his parents, who returned from a walk to find him crying with pain, drooling, and coughing.

On arrival at the emergency department, the child has a temperature of 37.4 °C, a
heart rate of 160 beats/min, a respiratory rate of 36 breaths/min, blood pressure of 100/70 mm Hg, and oxygen saturation of 87% in room air.

He is agitated and sweating.

On physical examination, there are mild
intercostal retractions.

Lung auscultation reveals good aeration with soft rales heard in the bases bilaterally.

There are no cardiac murmurs, rubs, or additional heart sounds, and his peripheral pulses are strong.

The child has rapid involuntary eye movements in all directions, tongue fasciculations, and normal strength and
reflexes in all extremities.

Of the following, the BEST next step in management is administration of

A. benzodiazepine

B. Centruroides (scorpion) antivenom

C. oxygen via nonrebreather mask

D. tetanus immunoglobulin and tetanus toxoid vaccine

11/10/2026

New American Society of Hematology guidelines on diagnosing iron deficiency (September 2026)

The American Society of Hematology (ASH) has released new guidelines on diagnosing iron deficiency using serum ferritin cutoffs [49]. These include ferritin ≤20 ng/mL in children 9 months to 4 years (and extrapolating through age 11 years), ≤30 ng/mL in adolescents and adults (including pregnant individuals), and ≤50 ng/mL in individuals with heavy menstrual bleeding, other iron deficiency risk factors, iron deficiency symptoms, upcoming surgery, or planning pregnancy. For adults with anemia of inflammation, they suggest using both ferritin and transferrin saturation (TSAT) and considering a diagnosis of iron deficiency with ferritin

27/09/2026

A mother who had no prenatal care delivers a term neonate.

She reports taking no medications during the
pregnancy.

On physical examination, the neonate is vigorous and breathing comfortably on the warmer, with normal vital signs.

He appears small for gestational age, and there is a small mass noted at the anterior neck.

The remainder of his examination findings are normal.

On further inquiry, the mother reports that several years ago she was prescribed medication to treat a thyroid problem that was diagnosed after she experienced significant weight loss.

Laboratory testing is performed on the neonate to assess his risk for developing signs and symptoms resulting from the mother’s condition.

Of the following, the BEST antibody level to obtain is

A. anti-thyroglobulin

B. anti-thyroid peroxidase

C. thyroid hormone receptor
D. thyrotropin receptor

22/09/2026

Congenital anomalies with vitamin B12 and folate deficiency (September 2026)

Maternal folate deficiency is known to increase the risk of neural tube defects. In a new study from China that analyzed over 17,000 individuals in a preconception cohort, maternal vitamin B12 or folate deficiency was associated with a greater risk of congenital anomalies in other organ systems, such as cardiac/circulatory, limb, and genitourinary, in a dose-dependent pattern (higher risks associated with more severe deficiency) [74]. In a separate group of over 3000 couples tested before conception, low vitamin B12 levels in either parent predicted a greater risk of congenital anomalies. The overall prevalence of congenital anomalies was low and consistent with other population estimates. These results reinforce the importance of identifying and treating these vitamin deficiencies.

20/09/2026

A previously healthy 9-year-old is seen for 3 days of sore throat and bilateral ear pain.

She has had no fever
or other upper respiratory tract symptoms.

Her vital signs are normal for age.

On physical examination, her ear and nose findings are normal.

Petechiae are seen on her soft palate, and her tonsils are 2+ in size,
injected, and without exudate.

The result of a rapid group A streptococcal antigen test is positive.

Of the following, the MOST likely etiology of this child’s ear pain is

A. group A streptococcal infection in the middle ear

B. mass effect of the palatine tonsils on the eustachian tubes

C. referred pain through the glossopharyngeal nerve

D. septic thrombophlebitis of the jugular veins

15/09/2026

Misleading marketing messages for toddler "formulas" (August 2026)

Milk beverages designed for children one to three years old, sometimes called toddler or follow-on "formulas," are costly and not generally useful or recommended. A new study describes common marketing messages and imagery for these products that are potentially misleading, including highlighting of DHA (docosahexaenoic acid) or probiotic content, paired with claims of health and cognitive benefits, despite no demonstrated benefits for this age group [4]. These findings support our recommendation for education of caregivers about these products, to balance misleading marketing messages and to encourage feeding of human milk (preferred) or vitamin D-fortified animal milks to children after 12 months of age.

13/09/2026

A 2-year-old child with a known seizure disorder is seen in the emergency department with altered mental status.

Earlier in the day he had a low grade fever, was more somnolent than usual, and had decreased oral intake.

The boy had a generalized tonic-clonic seizure, which stopped without treatment after 2 to 3 minutes.

The mother then administered 20 mg re**al diazepam.

Approximately 15 minutes later he was walking with a
wobbly gait and appeared even more somnolent.

On physical examination, the boy’s weight is 12 kg, temperature is 37.5 °C, heart rate is 85 beats per min,respiratory rate is 14 breaths per min, blood pressure is 85/55 mm Hg, and oxygen saturation is 98% in room air.

His pupils are midline, 2 mm, and sluggishly reactive.

General tone is diminished throughout with normal reflexes.

His mental status is significantly altered; he responds only to deep painful stimulation.

The remainder of his examination findings are unremarkable.

Of the following, the BEST next medication to administer to this child is

A. sodium bicarbonate
B. lorazepam
C. phenobarbital
D. flumazenil

10/09/2026

Clinical report on iron deficiency in children (June 2026)

A new clinical report on prevention, diagnosis, and treatment of iron deficiency in children has been published by the American Academy of Pediatrics and American Society of Pediatric Hematology and Oncology [10]. A key update is to use higher ferritin thresholds for diagnosing iron deficiency (≤20 ng/mL [45 pmol/L] for age ≥9 months through

08/09/2026

A 5-year-old child is undergoing evaluation for a sore throat, runny nose, and cough of 2 days’ duration.

On physical examination, the child appears well.

He has a temperature of 39 °C, a heart rate of 90 beats/min, a respiratory rate of 18 breaths/min, and an oxygen saturation of 100% in room air.

He has rhinorrhea and
pharyngeal redness with enlarged tonsils.

The remainder of his examination findings are normal.

He has had recurrent episodes of pharyngitis over the past 2 months, for which he has received multiple courses of antibiotics after testing positive for group A Streptococcus.

He is currently on day 8 of a 10-day course of
amoxicillin.

Of the following, the MOST appropriate care for this child is to

A. obtain respiratory viral testing

B. obtain a throat culture

C. prescribe amoxicillin-clavulanate

D. prescribe clindamycin