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5 year-old female with HPN dependence secondary to meconium pseudo-cyst develops acute agitation, headaches and vomiting immediately upon infusing HPN, which is a new batch from that was delivered yesterday. Of note, there have been no recent HPN prescription changes. Patient lives with parents in a...

You are consulted as the HPN expert by the inpatient cardiology team to facilitate discharge for a 3 year-old female with a history of heart transplant for hypoplastic left heart syndrome was admitted for new onset 3-week history of vomiting, diarrhea and weight loss. Diagnostic laboratory and...

Caregiver flushes the central venous catheter and they feel an unusual amount resistance to flushing. The catheter has the following appearance (see photo below). They call HPN on-call for advice. What is the first thing you should advise family to do? A. Offer reassurance if central line is not...

Family notices there is something unusual about the appearance of their child’s central line (see photo below). The line is functioning fine. There is no leaking. The patient is asymptomatic. What is the problem? A. Outer lumen fracture B. Inner lumen fracture C. Central line thrombus D. Central...

Patient complains of pain and burning during central line dressing changes with chlorhexadine. Central line exit site has the following appearance (see below). What is the proposed treatment plan? A. Use betadine cleanse for central line dressing changes for chemical burn. B. Prescribe IV...

Patient had redness near central line exit site. The central line was inserted 1 year ago. The patient has no fevers or chills. What is the next step? A. Remove suture. B. Remove central line. C. Prescribe broad spectrum antibiotics. D. Prescribe steroids. E. Reassurance Click here for answer Go to...

I am working on Boston Children's Hospital, Harvard Medical School, as a Instructor for medical image analysis. I received PhD cum laude at Department of Artificial Intelligence, University of Groningen, on March 17, 2017. During my PhD study, I worked at the project of MPS-the Medieval Paleographic...

Parent of a 1 year-old female on home parenteral nutrition secondary to short bowel syndrome (necrotizing enterocolitis) calls with a 2-day history of fever 101 degrees Fahrenheit (38.3 degrees Celsius). There are no other clinical complaints besides from teething. What is the next step? A...