Showing posts with label pediatric. Show all posts
Showing posts with label pediatric. Show all posts

Friday, January 7, 2011

- Hutchinson’s Triad.

Hutchinson's triad

It is a common pattern of presentation for congenital syphilis.
It consists of :-
  1. Interstitial keratitis
  2. Hutchinson incisors
  3. Eighth nerve deafness.

Dr Ibrahim
Return to other triads here.

Tuesday, June 8, 2010

-Complications of Tetralogy of fallot.

Complications of Tetralogy of fallot
"Inches"
Infective endocarditis,Low I.Q.
Neurological (e.g Brain abscess,cerebrovascular accidents)
Cyanotic spell,Clubbing.
Hematological(e.g polycythemia,IDA,Thrombosis).
Hyperuracemia and gout,Heart Failure (rare).
Exercise intolerance.
Squatting,scoliosis,Stunted growth.

Dr Ibrahim

Thursday, May 20, 2010

-No in ASD.

No in Atrial septal defect.

No murmur due to ASD itself but murmur of relative MS,PS.
No ACEIs if HF occur but give diuretics and digitalis.
No spontanous closure of ASD.
No symptoms or signs in small ASD.

Dr Ibrahim

Saturday, May 1, 2010

-Congenital Rubella Syndrome.

Congenital Rubella Syndrome
Aetiology:-
Maternal infection by rubella leads to Maternal viremia which lead to transplacental spread of the virus to the fetus causing fetal viremia whcih in turn leads to infection invloving many fetal organs and hence congenital anomalies.

N.B:- Newborn discharge virus in his secretions for 12-18 months after birth so he is infectious.
Incidence:-
*In the 1st trimester:- 15-20%.
*In the 4th month:- 5%.   

Friday, April 30, 2010

-Factors affecting human linear growth.

Factors affecting human linear growth.
  • Age
  • Sex
  • Race.
  • Hereditary factors:- Children of two short parents will probably be short and vice versa.
  • Endocrinal factors e.g Growth Hormone which is responsible for stimulation of body growth in humans.
  • Nutritional factors:- Adequate nutrients must be available for normal growth.
  • General health:- Any serious systemic disease in childhood is likely to reduce growth (e.g. chronic kidney disease or chronic infection).
  • Intrauterine growth retardation (small birth weight):-These infants often growpoorly in the long term.
  • Emotional deprivation and psychological factors:- These can impair growth by complex, poorly understood mechanisms.
  • Chromosomal abnormalities.
  • Skeletal maturity.
Dr Ibrahim

Monday, March 29, 2010

- Medical treatment of hydrocephalus.

Medical treatment of hydrocephalus

*Aim:-
Medical treatment is used to delay surgical intervention.

*Medical treatment is not effective in long-term treatment of chronic hydrocephalus. It may induce metabolic consequences and thus should be used only as a temporizing measure.

*Lines of TTT:- "Fair"
  • Furosemide:1mg/kg/day.(Decreasing CSF secretion).
  • Acetazolamide 5mg/kg/day.(Decreasing CSF secretion).
  • Isosorbide (Increasing CSF reabsorption).
  • Restriction of water and salts.
Dr Ibrahim

Saturday, March 27, 2010

- Skull causes of macrocephaly.


Skull causes of Macrocephaly.
"Oscar"

Osteogenesis imperfecta.
Secondaries especially neuroblastoma.
Chronic hemolytic anemia.
Achondroplasia.
Rickets.

Dr Ibrahim

Thursday, March 25, 2010

-Guillain Barré syndrome.

Guillain Barré syndrome

Aetiology(theories):-

  • Postinfection:50% of cases have preceding respiratory or GIT viral infection.
  • Post vaccination:following vaccination against swine flu virus.
  • Lymphoma.
  • Autoimmune theory.
Clinical Picture:-
1-Initial febrile illness.
2-Motor affection:-

  • Bilateral symmetrical ascending affection of both lower limbs,trunk,upper limbs,Bulbar muscles,facial muscles then diphragm and respiratory muscles.
  • The Affection is proximal more than distal in adult.
  • The Affection is proximal more than distal in infant and childrens.
  • Weakness is associated with hypotonia and areflexia.

Friday, January 22, 2010

- Grades in medicine.

Grades in medicine 

In many branches of medicine we meet what is called "grades" this grades were put to classify certain conditions. Here I will put the grades what i had found as they meet me in books in simple way......... so you can share us.
Dr Ibrahim

Sunday, January 17, 2010

- Parasites transmitted through trans-mammary route.

Parasites transmitted through trans-mammary route
(International Breastfeeding Symbol)

"SAT"
Strongyloides stercoralis larvae.
Ancylostoma duodenale larvae.
Toxocara canis and cati  larvae.

Dr Ibrahim 

Sunday, January 10, 2010

- Grades of respiratory distress.

Grades of respiratory distress
  1. Grade I (mild distress):- tachypnea ,working ala nasi and tachycardia .
  2. Grade II (moderate distress):- Chest retraction "in-drawing" (e.g subcostal and intercostal) due to moderate hypoxemia.
  3. Grade III (severe distress):- Grunting which is due to severe hypoxemia and indicate alveolar lesion (i.e parenchymatous lung disease).Here O2 supply is needed and patient must be hospitalized.Grunting is the last compensatory mechanism.
  4. Grade IV:- Cyanosis and disturbed consciousness and endotracheal tube is needed here.

Dr Ibrahim

Return to list of medical grades (click here) 

Friday, January 8, 2010

- Grades of Dyspnea.

Grades of Dyspnea
Two scoring systems can be adopted to evaluate the dysnea changing it from subjective complaint to objective complaint.

1-American Thoracic society score (ATS):
Grade 0:- No breathlessness except with strenuous exercise.
Grade 1:- Breathlessness when hurrying on the level or walking up a slight hill.
Grade 2:- Walks slower than people of the same age on the level because of breathlessness or has to stop for breath when walking at own pace on level.
Grade 3:- stop for breath after walking about 100 yards (96 meter) or a few minutes on the level.
Grade 4:- Too breathless to heave the house or breathless when dressing or underdressing.

2-New york heart association score (NYHA)

There are four functional  grades of  Dyspnea as follows:-

1. Grade I (minimal Dyspnea):  Dyspnea on running or on doing more than ordinary effort .

2. Grade II : on doing ordinary effort .

3. Grade III (considerable Dyspnea) : on doing less than  ordinary effort .
4. Grade IV : Dyspnea at rest.

*Ordinary effort is that of the person himself as regard his previous effort tolerance and usual life style.

*Reference:-
- Basics of respiratory medicine,Staff members,Thoracic medicine department,mansourauniversity,3ed,2009,symptoms of chest disease P.g 57.

Return to list of medical grades (click here) 

Thursday, December 24, 2009

- Breast feeding.

Breast feeding
(International Breastfeeding Symbol)

- Breastfeeding is the feeding of an infant or young child with breast milk directly from human breasts.

Advantages of Breast Feeding
( the breast is the best)

(1)For Infants:-
"Human breast milk is the healthiest form
of milk for human babies"
(1) How?

*It is biochemically the most suitable for infant feeding at any stage (colostrum,transitional and mature milk).
*It contain various elements required for nutrition of infant.
*It is hypoallergic (2) and may reduce subsequent atopic diseases .
*Naturally stored at room temperature.
*Available whenever needed and automatically adjusted to infant needs.
*Anti infective properties how?
- It is naturally sterile as no preparation nor contamination.
- It contain various antimicrobial factors :-

Wednesday, December 16, 2009

- Oculo-cerebro-renal Syndrome.

Oculo-cerebro-renal Syndrome


-Def:- It is a X-linked recessive disorder of eye,cerebral cortex and renal tubules .

-Synonyms (1):-
  • Lowe's oculocerebrorenal disease/syndrome.
  • Lowe's disease/syndrome.
  • Oculocerebrorenal dystrophy.
- The condition became known as "Lowe syndrome" named after Dr. Charles Lowe, the senior member of the group that described it.

-Clinical picture:-

Sunday, December 13, 2009

- Light Wood-Albright syndrome.

Light Wood-Albright syndrome
Lightwood syndrome
Renal tubular acidosis (RTA) (Type-2)
(Proximal RTA)



-Pathophsiology:-

it is caused by failure of the proximal tubular cells to reabsorb filtered bicarbonate from the urine, leading to urinary bicarbonate wasting and subsequent metabolic acidosis.

-Clinical picture:-

Monday, December 7, 2009

- Abderhalden-Kaufmann-Lignac syndrome.

"Abderhalden-Kaufmann-Lignac syndrome"

"cystinosis"


-Def:- it is an autosomal recessive disorder involving deposits of cystine crystals in lysosomes of liver,spleen,bone marrow,cornea, and renal tubules due to abnormal metabolism of cystine .

-Incidence :- 1 : 100,000- 1 :200,000.

-It is the most common cause of Fanconi syndrome in the pediatric age group.

-Clinical picture:-

Friday, December 4, 2009

- Fanconi's syndrome.


"Fanconi's syndromes"

* There are many types of Fanconi's syndrome according to
etiology
:-


-Primary type
-Hereditary:-
  • Abderhalden-Kaufmann-Lignac syndrome "cystinosis" (click here).
  • Oculo-cerebro-renal Syndrome (Lowe's Syndrome) (click here).
  • Galactosemia.
  • Wilson disease.
-Drug induced:-
  • Out dated tetracycline.
  • Cyclosporin.
  • Heavy metals (e.g lead poisoning).

*Fanconi's syndrome ( primary type)*

-Def:- it is an autosomal recessive disorder due to multiple defects in proximal renal tubules which decrease the urinary re-absorption of phosphate,bicarbonate,glucose, amino acids and may be Potassium ( they all are lost in urine).

-It is named after Guido Fanconi, a Swiss pediatrician.

-Clinical picture:-

Saturday, November 28, 2009

- Complete blood count exams.

Some examples of Complete blood count exams

from Mansoura University Children Hospital

If you know the answer ...post it in a comment

CBC 1



CBC 2



CBC 3




CBC4




CBC 5



CBC 6




Dr Ibrahim

Thursday, November 26, 2009

- Grading of Vesicoureteric Reflux.


International Classification of Vesicoureteric  Reflux.

  •  Grade I: – reflux into lower part of a  non-dilated ureter.
  •  Grade II: – reflux into the renal pelvis and calyces without dilatation
  •  Grade III: – reflux into a mildly dilated ureter, renal pelvis and calyces with minimal blunting of the fornices
  •  Grade IV :– marked dilaed ureter.
  •  Grade V:– massive reflux with gross dilatation of the ureter, pelvis and calyces; ureteral tortuosity; loss of papillary impressions.
- N.B:-
*In grades I,II ureter isn't dilated.

Return to list of medical grades (click here) 

Tuesday, November 24, 2009

- Grading of Murmurs.


Grading of Murmurs


- Intensity of murmur refers to the amplitude of sound of murmur (i.e loudness of the murmur)
- Murmurs are classified ("graded") depending on their ability to be heard by the examiner.
- It is graded on a scale from I to VI (1-6/6).

-Grades:-
  • Grade I:- very faint,not heard in all positions,no thrill.
  • Grade II:- Soft,heard in all positions,no thrill.
  • Grade III:- loud,no thrill.
  • Grade IV:- Loud,with palpable thrill (i.e a tremor or vibration felt on palpation).
  • Grade V:- Very loud, with thrill,heard with only the edge of the stethoscope touching the chest wall.
  • Grade VI:- loudest, with thrill,heard with the stethoscope just above the precordium, not touching the skin.




Dr Ibrahim

Return to list of medical grades (click here)