Pediatrics is easy

02/02/2026

Innocent murmurs have seven features, known as the Seven S’s:

Sensitive: change with respiratory variation/position (louder when supine,
decrease with Valsalva)
Short: brief duration (not holosystolic)
Single: no clicks or gallops
Small: nonradiating, focal
Soft: low amplitude
Sweet: not harsh
Systolic: never diastolic

27/01/2026

A 7-year-old child is seen in the clinic for concern about his size.

He is currently the smallest child in his class, but his mother reports that at the start of kindergarten, he appeared to be of average height compared with his classmates.

Over the past few months, he has had frequent loose stools and intermittent abdominal pain.

Review of systems is otherwise negative.

The family history is notable for an older sister with type 1 diabetes mellitus.

On physical examination, the boy is small for age with a mildly protuberant abdomen.

His examination
findings are otherwise unremarkable.

Laboratory data are shown:

White blood cell count 5,800/µL (5.8 x 10 /L)
Hemoglobin 10.6 g/dL (106 g/L)
Mean corpuscular volume 68 fL
Platelet count 344 x 10 /µL (344 x 10 /L)

Glucose 85 mg/dL (4.4 mmol/L)

Aspartate
aminotransferase
16 U/L
Alanine aminotransferase 18 U/L

C-reactive protein 0.3 mg/dL (3 mg/L)

Hemoglobin A1c 4.7%

Total IgA 95 mg/dL (reference range, 50-220 mg/dL)
Tissue transglutaminase
IgA 83 units (reference range, negative 10 units)

Ferritin 2 ng/mL (2 µg/L)

Of the following, the BEST next step in management is

A. administration of oral iron supplementation

B. initiation of a strict gluten-free diet

C. referral to a pediatric gastroenterologist

D. supplementation with a high-calorie nutritional drink

20/01/2026

Pediatric secrets:
Don’t forget to palpate the femoral pulse in any critically ill neonate

20/01/2026

20/01/2026

https://pediatricsiseasy.com/
Find more on website

17/01/2026

A 6-week-old infant born at 30 weeks’ gestation is in the neonatal intensive care unit.

He is currently in room
air maintaining adequate oxygen saturation, and has been weaned to a crib.

His diet is 160 mL/kg/day of expressed breast milk with human milk fortifier (24 kcal/oz).

He takes about 60% of his feedings orally; the
remainder is provided via nasogastric tube.

The infant has never received a blood transfusion.

The infant’s weight gain over the last 7 days has been approximately 25 g/day; his current weight is 1.9 kg.

He has occasional episodes of bradycardia and desaturation that mainly occur during feedings and are self
resolving.

His heart rate is 140 beats/min, his blood pressure is 62/32 mm Hg, and his mean arterial blood pressure is 40 mm Hg.

His current medications are ferrous sulfate 3.75 mg once per day and a multivitamin 1 mL per day.

His recent laboratory findings are as follows:

Hemoglobin 8.2 g/dL (82 g/L)
Hematocrit 25%
Reticulocyte count 5.4%

Of the following, the BEST next step in this infant’s care is to

A. administer a blood transfusion

B. continue his current dose of ferrous sulfate

C. increase the caloric value of his feedings to 26 kcal/oz

D. prescribe a multivitamin with iron
To find more cases like this join my website

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13/01/2026

To see more x rays join my website

https://pediatricsiseasy.com/

Child with anemia since early life
What is this sign?

12/01/2026

What is new in pediatrics ?!
Tonsillectomy for periodic fever with aphthous stomatitis, pharyngitis, and adenitis (January 2026)
Periodic fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is a periodic fever syndrome that is self-limited and has no long-term sequelae, but it can negatively impact quality of life. Thus, choice of therapy is highly dependent upon patient/caregiver preferences and potential adverse effects of each therapy. A meta-analysis of randomized trials and observational studies with 691 children found that tonsillectomy was associated with decreased symptom burden compared with medical treatment. This analysis confirms that tonsillectomy is a reasonable treatment choice, particularly for patients who do not respond to or tolerate medical management or whose episodes are frequent, highly disruptive, and affect quality of life.
If you want to know more about what is new in pediatric join my website

Whether you're a new resident mastering the basics, a busy practitioner seeking fast clinical answers, or a senior consultant staying ahead of the latest trends— we've got you covered.

10/01/2026

A 2-month-old term infant was seen in the clinic for a health supervision visit.

He has been exclusively fed a standard cow milk protein formula.

His parents reported frequent large-volume spit-ups immediately
following each feed.

He displayed no evidence of pain or discomfort during these episodes.

At that visit, both
his weight and length were at the 25th percentile for age.

They were counseled regarding appropriate
feeding volumes, and a recommendation was made to thicken the feeds using oatmeal, barley, or a multigrain infant cereal, which they have followed.

At his 4-month visit, his parents report similar symptoms.

His weight is at the 10th percentile, and his length is at the 25th percentile for age.

He is meeting all developmental milestones.

Of the following, the BEST next step in management is

A. initiation of a histamine-2 receptor antagonist

B. initiation of a proton pump inhibitor

C. referral to a pediatric gastroenterologis

D. trial of an extensively hydrolyzed protein-based formula

06/01/2026

Single-dose HPV vaccine schedule (December 2025)

Human papillomavirus (HPV) vaccination effectively prevents cervical cancer, but vaccine hesitancy and logistical barriers limit vaccine uptake globally. While the United States recommends a two- or three-dose HPV vaccine series, growing evidence lends support to a single-dose approach. In a randomized trial of over 20,000 girls aged 12 to 16 years old in Costa Rica, single-dose or two-dose vaccination similarly prevented incident HPV16 or HPV18 infection over five years (97 percent vaccine efficacy or higher) [57]. The single-dose HPV vaccine schedule is an option recommended by the World Health Organization and in other countries

06/01/2026

Pediatric secrets 6

Additionally, iron should be given as a once-daily dosing. When iron is given in
divided doses each day, this has been shown to increase serum hepcidin levels and
therefore reduces enteral absorption

04/01/2026

A previously healthy 2-month-old term infant is brought to the emergency department for evaluation.

He has had 1 week of progressive forceful nonbilious emesis after feedings with a 2-pound weight loss.

There has been no fever, diarrhea, respiratory symptoms, or known exposures to sick contacts.

He was delivered through an uncomplicated repeat cesarean section.

His mother did not take any medications other than prenatal vitamins.

Newborn screening results were normal.

On physical examination, the infant appears lethargic and has dry mucous membranes, a mildly sunken anterior fontanelle, and decreased skin turgor.

He has mild tachycardia. His abdomen is soft and
nondistended with hypoactive bowel sounds.

Abdominal sonography reveals an elongated pyloric channel (18 mm) with increased pyloric thickness (5 mm).

A serum electrolyte panel is obtained, and intravenous fluid
resuscitation is initiated.

Of the following, this infant’s laboratory findings will MOST likely include

Serum Sodium
Level
Serum Potassium
Level
Serum Bicarbonate
Level
Serum Chloride
Level

A. Low low high low

B. low high low low

C. low high high normal

D. Low low low high