Poor Weight Gain in Pediatrics — Case | General Pediatrics | SMLE Q#636
SMLE Question #636
Pediatrics
General Pediatrics
Last updated: February 2026
A 9-month-old boy is evaluated for poor weight gain. Over 4 months, his weight dropped from the 40th percentile to below the 3rd percentile; length and head circumference decreased from the 40th to the 10th percentiles. He tires during feeds, sweats on his forehead while feeding, and takes a long time to finish a bottle. Examination shows mild subcostal retractions, hepatomegaly 3 cm below the right costal margin, and a holosystolic murmur best heard at the left lower sternal border. What is the most likely underlying diagnosis causing this child’s failure to thrive?
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