Pediatrics Questions Channel πŸ’‰πŸ’Š
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🩺 Daily Pediatrics Q&A | Clinical Scenarios | Evidence-based Notes | For Med Students & Practitioners.

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A 45-year-old man with a history of alcohol-induced acute pancreatitis presents 6 weeks later with persistent epigastric fullness and early satiety. CT scan shows a 7-cm well-defined fluid collection adjacent to the pancreas with a mature wall. Next step?
Anonymous Quiz
16%
Immediate surgical resection
16%
Observation only
32%
Endoscopic drainage
8%
Start IV antibiotics only
27%
Percutaneous aspiration without catheter
A 38-year-old woman is found incidentally to have a 4-cm pancreatic pseudocyst 3 weeks after mild pancreatitis. She is asymptomatic. What is the most appropriate management?
Anonymous Quiz
6%
Immediate endoscopic drainage
14%
Percutaneous catheter drainage
11%
ERCP with stent placement
8%
Surgical cystogastrostomy
60%
Observation with repeat imaging
During central venous catheter removal, a patient suddenly develops dyspnea and hypotension. What is the immediate first step in management?
Anonymous Quiz
8%
Start IV antibiotics
62%
Place patient in left lateral decubitus with head down
5%
Give diuretics
14%
Begin thrombolysis
11%
Intubate immediately without positioning
During central venous catheter removal, a patient suddenly develops dyspnea and hypotension. What is the immediate first step in management?
Anonymous Quiz
8%
Start IV antibiotics
62%
Place patient in left lateral decubitus with head down
5%
Give diuretics
14%
Begin thrombolysis
11%
Intubate immediately without positioning
πŸ–Š Percutaneous Transhepatic Cholangiography (PTC) is indicated when ERCP is unsuccessful or unavailable.

In this procedure, contrast material is injected into the bile ducts through the insertion of a transhepatic needle

PTC allows therapeutic interventions such as infected bile drainage and biliary tract stone extraction.
πŸ–Š Osteosarcoma

πŸ”Ή Typically presents with pain and soft-tissue swelling without systemic symptoms
πŸ”Ή Codman triangle: periosteum is pushed away from the bone
πŸ”Ή Sunburst pattern: radiating bone fibers/spicules form in the periosteum due to aggressive new bone formation
πŸ–ŠAcute colonic pseudo-obstruction (Ogilvie’s syndrome)
πŸ”Ή Typically presents 3 - 7 days after surgery in men aged > 60 years

Versus postoperative ileus:
πŸ”Ή Usually causes dilation of both the large and small bowel
πŸ”Ή Typically develops before the return of bowel function
πŸ–Š Progression of Hematogenous Osteomyelitis
πŸ–Š Acute interstitial nephritis affects the interstitium and the renal tubules. (aka tubulointerstitial nephritis)