Dr. Thomas James Connolly

A true purulent ear infection would get antibiotics such as amoxicillin, augmentin, cefdinir, or azithromax if penicillin allergic. The other possible medications that could help would be if the patient has underlying allergies causing nasal congestion that has not been treated. Could add antihistamines such as Claritin or Zyrtec with a nasal steroid like Flonase. Decrease in nasal congestion typically improves ear symptoms. Dr C

Anemia can be a complex condition. Most kids it is a straight forward iron deficiency from drinking lots of milk and little iron fortified food. Place the child on iron supplementation for 3-6 months and adjust diet and that typically works. However, if the underlying anemia is genetic thalassemias, sickle cell anemias,etc.. then consultation with a hematologist (blood doctor) would be warranted so as not to iron overload the child. Another etiology for anemia is lead poisoning which is unfortunately is common with old water supply systems for towns and cities. Dr Connolly

Yes. Most throat infections are viral. If your child has headache, sore throat, and stomachaches, then you should get your child tested for a strep infection that responds quickly to penicillin. If your child does not want to turn her head and or swallow fluids, she should get seen by a provider for atypical infections. Tom

Depends on how the provider is thinking of the underlying etiology of the pneumonia and if the child has any underlying conditions that can be compromised by the pneumonia. If the provider feels the child has a straightforward community acquired pneumonia he/she will prescribe an antibiotic such as amoxicillin. If he/she feels that it is viral, he would educate about supportive care and warning signs for if the child became worse. He/she would hold off starting antibiotics. If the child has underlying asthma he/she would want to make sure the childs asthma medications are updated and recommend the frequency of use. How often to use the Albuterol and if steroid medications need to be started. If the child is having hypoxia (low oxygen levels, typically <90 on the pulse oximeter)with the pneumonia, then child most likely admitted to the hospital for closer monitoring and treatment. Dr Connolly

In general, Claritin and Zyrtec are long acting antihistamines. Claritin is dosed once a day with only a 3% sedation effect. Zyrtec can be dosed once or twice a day. Most kids seem to do better on a twice a day regimen. 20% of kids starting Zyrtec will have sedating side effect experience. I usually recommend families to pair antihistamines with the family genetics/ allergy history. So if dad has allergies and does better on Claritin, then I would recommend Claritin as first trial for his childs allergies. Dr Connolly

The diagnosis of autism is not necessarily straightforward. Yes, for some of those diagnosed with autism there are genetic components to it. Talking with geneticists and or developmental pediatricians can help decide if genetic testing would be warranted ( genetic testing in general is not cheap). Current familial risk for having another child with autism is 10% but I know that number is changing as more genes are discovered to be associated with autism. Treatment depends on the severity of the autistic behaviors. The more severe behaviors are typically referred to ABA therapists to help the child and family find a way to communicate to each other. Very labor intensive. ABA refers to Applied Behavioral Analysis. Milder forms of autism might just need referral for speech, physical, and or occupational therapy. When the child is school age, medications might be incorporated for some of his behaviors- poor focus, anxiety, or pervasive ones. Each child with autism is unique and the treatment plan will need to be adjusted as the childs brain is maturing and changing as well. Dr Connolly

If the child has signs of virilization - hair in axilla and mons area, increase in growth and muscle, then she would need to get a referral to see a pediatric endocrinologist to evaluate her hormone levels. If no other signs of virilization, then can see the pediatrician for reassurance especially if she has an upcoming well check appointment. If mom is using a moisturizer that has plant estrogens (phytoestrogens) on her skin she might be responding to the plant hormone. Can stop the moisturizer and typically the tissue will recede back. Dr Connolly

Short term, he would be okay if no breathing issues initially. The longer it stays stuck, wedged up in a turbinate sulcus, it can become an infectious source secondary to surrounding inflammation to a foreign body. If press against is nares / nostril and feels firm bump especially if it is tender, he should get evaluated by a doctor.

Cancers are typically genetic based not from a traumatic birth. If you have sebaceous adenoma in your scalp, that can become cancerous over your lifetime (local skin cancer). I have not heard that a traumatic birth is the cause of the sebaceous adenoma. I was under the impression is was based during the pregnancy when the skin patterns where forming and there was a gap or insult at the time and the adenoma gland filled in the gap.

Get seen by a medical provider. High likelihood of a UTI or pyelonephritis as strong possibilities.

Did he mention mitral valve prolapse (MVP) which can be common in women? If you are having chest pain/rapid heart beats with pain/numbness extending to left arm I would talk with the doctor again or get a referral to cardiology. If you are having a panic attack worrying about the heart beat, you might get numbness/tingling in both hands/arms and not just left arm only.
You probably need to rediscuss the symptoms and your concerns. MVP is usually diagnosed after an ECHO but some doctors might feel comfortable listening to the click/snap when using a stethoscope.

He might be eating string/shoelaces as one possibility. Pinworms are white and small so doubtful. Usually other worms like tapeworms can be long but are fleshy looking. Would recommend seeing a doctor or at least take pictures to show his doctor what is coming out as way to start the conversation.

There is no formal vaccine for cat scratch disease. The only vaccine to contemplate is if the child was behind on his/her tetanus boosters (the scratch occurred outside with the cat).