Immediate Questions

A. How has infant been acting and feeding? A toxic-appearing child needs to be evaluated for sepsis or acute infection. Irritability and poor feeding may be a sign of neurologic effects of metabolic disorders, severe hepatic decompensation, or infection.

B. Has infant been growing and developing as expected? Many metabolic conditions cause developmental delays. Significant liver disease often results in poor weight gain and growth.

C. Has infant had fever? Sepsis, UTI, and cholangitis may present with fever. Bacterial peritonitis must also be considered in a patient with ascites and fever.

D. Is abdomen distended? Abdominal distention often represents organomegaly or ascites, both seen with progressive liver dysfunction.

E. What is the color of stool and urine? Acholic (clay-colored or pale) stool and dark urine suggest biliary obstruction (eg, biliary atresia), which requires urgent evaluation for timely surgical referral.

Gaining Weight 101

Gaining Weight 101

Find out why long exhausting workouts may do more harm than good. Most of the body-building workout and diet regimens out there are designed for the guys that gain muscle and fat easily. They focus on eating less and working out more in order to cut the excess fat from their bodies while adding needed muscle tone.

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