17. CONGENITAL
HYPOTHYROIDISM
CAUSEDE BY –THYROID AGENESIS
ECTOPIC THYROID
MATERNAL INTAKE OF ANTI
THYROID DRUGS
CLINICAL FEATURES
• SLUGGISH FEEDING
• CONSTIPATION
• LETHARGY
• SLEEP MORE NEEDS TO AWAKE MORE
• HOARSE CRY
• HYPOTHERMIA
• PROLONGED JAUNDICE
• HYPOTONIA
18. MONGOLIAN SPOT
PHYSIOLOGICAL CONDITION
• CAUSED BY PIGMENT IN SKIN
• IT IS FLAT ,BLUE GREY IN COLOUR
• MAINLY IN LAMBOSACRAL REGION ,BUT
MAY OCCUR ANYWHERE ON TRUNK OR
LIMBS
20. PALMAR GRASP
IT IS A PRIMITIVE GRASP REFLEX,BEGEIN AT
32 WEEKS POF GESTATION
LIGHT TOUCH OF PALM PRODUCES REFLEX
FLEXION OF FINGERS
DISSAPEARS AT 3-4 MONTHS OF AGE
21. MICROCEPHALY
DEFINED AS HEAD CIRCUMFERENCE < 3 SD OF MEAN
FOR AGE AND SEX
• CLASSIFICATION
PRIMARY/GENETIC
SECONDARY/NON GENETIC
• SYNDROMES –DOWN
EDWARD
CRI-DU-CHAT
RUBINSTEIN TAYBI
• C/F-MENTAL RETARDATION
DELAYED MOTOR MILESTONES
DELAYED SPEECH
HYPERACTIVITY
SEIZURES
DIFFICULTY IN COORDINATION AND BALANCE
23. MEGALOBLASTIC
ANAEMIA
IT IS DUE TO DEFICIENCY OF B12 AND FOLIC
ACID
• RESULTS FROM INHIBITION OF DNA
SYNTHESIS IS IMPAIRED DURING RBC
PRODUCTION
• IT IS MACROCYTIC HYPOCHROMIC
ANAEMIA
• DECREASED RBC COUNT AND HB
• INCREASED MCV(>100) AND MCH
• NORMAL MCHC
• DECREASED RETICULOCYTE COUNT
• PS-HYPERSEGMENTED NEUTROPHILS
24. KAYSER FLEISCHER RING
COMMON OPHTHALMOLOGICAL FINDINGS
IN PATIENTS OF WILSONS DISEASE
• DUE TO ACCUMULATION OF COPPER ON
THE INNER SURFACE OF THE CORNEA IN
THE DESCEMENTS MEMBRANE
• KF RING IS SEEN IN M OST OF THE
PATIENTS WITH NEUROLOGIC
INVOLVEMENT
• SLIT LAMP EXAMINATION IS MANDATORY
TO MAKE A DIAGNOSIS OF KF RING
• DO NOT CAUSE ANY VISION IMPAIRMENT
BUT DISAPPEARS WITH TREATMENT AND
REAPPEARS WITH DISEASE PROGRESSION
25. VITAMIN A DEFICIENCY
WHO CLASSIFICATION OF VITAMIN A DEFICIENCY
• PRIMARY SIGNS –
X1A-CONJUNCTIVAL XEROSIS
X1B-BITOTS SPOTS
X2-CORNEAL XEROSIS
X3A-CORNEAL ULCERATION/KERATOMALACIA <1/3 OF CORNEA
INVOLVED
X3B-CORNEAL ULCERATION/KERATOMALACIA >1/3 OF CORNEA
INVOLVED
• SECONDARY SIGNS-
XN-NIGHT BLINDNESS
XF-FUNDAL CHANGES:XEROPHTHALMIC FUNDUS
XS-CORNEAL SCARS
26. HYDROCEPHALOUS
ACCUMULATION OF CSF WITHIN THE VENTRICLES OR CAVITIES OF
BRAIN DUE TO INCREASED PRODUCTION
/OBSTRUCTION/DECREASED ABSORPTION OF CSF
• SIGNS –MACROCEPHALY,HIGH PITCHED CRY
SUTURAL SEPERATION CAN BE SEEN
DELAYED CLOSURE OF FONTANELS
SUNSET SIGN-DUE TO UPWARD GAZE PALSY –UPPER
EYELID IS RETRACTED AND THE EYEBALLS ARE ROLLED
DOWNWARD DUE TO HYDROCEPHALIC PRESSURE ON
MESENCEPHALIC TEGMENTUM AND PARALYSIS OF UPWARD GAZE
SCALP VEINS DILATED
MACEWEN SIGN
27. BELLS PALSY
IDIOPATHIC U/L LMN TYPE OF FACIAL NERVE
PALSY NOT ASSOCIATED WITH OTHER
CRANIAL NEUROPATHIES/BRAIN STEM
DYSFUNCTION
IT MOSTLY OCCURS AFTER 2WEEKS OF
SYSTEMIC VIRAL INFECTION (EBV)
28. CONGENITAL CATARACT
CLOUDING OF LENS OF EYES THAT IS
PRESENT AT BIRTH
CAUSES
• TORCH INFECTIONS DURING PREGNANCY
• SYPHILIS DURING PREGNANCY
• METABOLIC CAUSES-GALACTOSEMIA
29. MEASLES
EXANTHAMATOUS ILLNESS
RASH USUALLY APPARENT ON 4TH DAY OF
ILLNESS
KOPLIKS SPOTS –PATHOGNOMIC OF
MEASLES,GREY /WHITE LESIONS
RESEMBLING GRAINS OF SAND WITH
SURROUNDING ERYTHEMA,APPEARS ON 2-3
DAY,OPPOSITE TO LOWER 2ND MOLAR ON
BUCCAL MUCOSA
COMPLICATIONS-OTITIS MEDIA
BACTERIAL
BRONCHOPNEUMONIA
DIARRHOEA
SSPE
30. ASYMMETRICAL TONIC
NECK REFLEX
WHEN THE CHILD HEAD IS TURNED TO ONE
SIDE THE ARM ON THAT SIDE WILL STRAIGHT
AND OPPOSITE ARM WILL FLEX
APPEARS BY 2-3 MONTHS OF AGE
THIS DISAPPEARS BY 6-8MONTHS
31. KAWASAKI DISEASE
ACUTE FEBRILE MUCOCUTANEOUS
LYMPHNODE SYNDROME
CRITERIA –AGE >5YEARS WITH HIGH GRADE
FEVER LASTING > 5DAYS
• PRESENCE OF ANY 4 OUT OF 5
• B/L NON PURULENT CONJUNCTIVITIS
• MUCOSAL CHANGE OF
OROPHARYNX(STRABERRY TONGUE)
• CHANGES OF PERIPHERAL
EXTRIMITIES(edema,erythema of hand
and feet)
• Polymorphous rash
• u/l Cervical lymphadenopathy