-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

- 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

- Skull causes of macrocephaly.

Skull causes of Macrocephaly.

"Oscar"

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

Dr Ibrahim

-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.
  

-Henoch-Schonlein purpura.

Allergic purpura
Anaphylactoid purpura
(Henoch-Schonlein purpura)

(Purpura on the right lower leg of a child)

-Def:- is an allergic disorder in which the allergic reaction occur in the
wall of blood vessels in "JARS"

• Joints
• Abdomen(GIT)
• Renal(kidney)
• SKIN

-Aetiology:- (Antigen)
1-Infection.
2-Food or drug allergy.
3-Insect bite.

-Symptoms:-

• Purpura, arthritis and abdominal pain are known as the classic triad of Henoch–Schönlein purpura (1).
• Bluish purple bruises (purpura)— most often on Joints .
• Swollen, achy joints.
  fever.
• Bleeding in the digestive tract may cause abdominal pain.
• Hematuria may develop.
• Bleeding in the kidneys may cause kidney damage.

The diagnosis is based on the symptoms.

Prognosis:- Most people recover completely within a month, but symptoms may recur several times.

Return to other triads here.

-References:-
(1) Kraft DM, Mckee D, Scott C (1998)"Henoch-Schönlein purpura: a review" Am Fam Physician 58 (2): 405–8, 411. PMID 9713395.