Case 1

An 18-month-old girl presents with abdominal pain, vomiting and drowsiness for one week. Her parents report she has also been drinking more than normal and is once again wetting the bed. On examination she is alert, tachycardic (HR180) but normotensive with dry mucous membranes, sunken eyes and a CRT of 3-4 seconds. Her peripheral pulses are weak and thready.