introduction to pediatrics

1. INTRODUCTION TO PEDIATRICS
Dr kawir: MD, MPH, FGHR, MoTMID.
Dr kawir: MD, MPH, FGHR, MoTMID.

2. DEFINITION
• Pediatrics is concerned with the health of infants, children
and adolescents.
• Their growth and development, and their opportunity to
achieve full potential as adults.
• Pediatricians are medical doctors who have specialized
training in evaluating, diagnosing and treating children.
Dr kawir: MD, MPH, FGHR, MoTMID.

3. Objects:
infants, children and adolescents(0~18yrs)
 regular rules of growth and development.
 physical and mental health care diseases.
To improve children’s physical, mental, behavioral,
psychological and social health.
Reduce their morbidity & mortality.
Dr kawir: MD, MPH, FGHR, MoTMID.

4. Dr kawir: MD, MPH, FGHR, MoTMID.

5. Dr kawir: MD, MPH, FGHR, MoTMID.

6. CHARACTERISTICS OF PEDIATRICS
Basic Medicine
Clinical Medicine.
• A child’s growing up deals with physical growth, organs’
functional maturation, and cognitive, motor and emotional
development, which results in differences between children and
adults and even among children at age.
Dr kawir: MD, MPH, FGHR, MoTMID.

7. BASIC MEDICINE
 Anatomy
 Physiology and Biochemistry
 Nutrition and Metabolism
 Immunology
 Pathology
Dr kawir: MD, MPH, FGHR, MoTMID.

8. Changing in the appearance: weight, height, circumferences
of head, chest, and arm, and body proportions
Skeletal development: Anterior fontanel closes, ossification
center occurs
Size, position of viscera, skin, muscle, nerve and lymph system
vary in different age.
Dr kawir: MD, MPH, FGHR, MoTMID.
ANATOMY

9. Changes in body proportions from the 2nd fetal mo to adulthood.
The child is not an anatomical miniature of the adult.
Proportional differences exist between the young infant, older infant, child and
adult. Dr kawir: MD, MPH, FGHR, MoTMID.

10. During the organs’ developmental progress, children face
more risk factors.
 limited kidney's ability leads to electrolyte and Acid-Base
disorders in children.
 history, and physical examination are greatly influenced by
a child's developmental stage:
–heart rate, blood pressure, composition of body fluids.
Dr kawir: MD, MPH, FGHR, MoTMID.
PHYSIOLOGY AND BIOCHEMISTRY

11. The dramatic growth of children during the beginning
period of life demands unique nutrients.
provision of these special nutritional needs is complicated
by the immature digestive and metabolic processes.
Dr kawir: MD, MPH, FGHR, MoTMID.
NUTRITION AND METABOLISM

12. IMMUNOLOGY:
3-5 months after birth, the diminished concentration of
immunoglobulin and other immunologic factors and the decreased
function of neutrophils and other cells involved in the response to
infection put infants at ongoing high risk for infection.
Other immunologic factors include complement, T cell and
macrophage system.
Dr kawir: MD, MPH, FGHR, MoTMID.

13. Infants: Adolescents or
Adults
Streptococcus
pneumonia
bronchopneumonia Lobar pneumonia
Vitamin D
deficiency
Rickets osteomalacia
Dr kawir: MD, MPH, FGHR, MoTMID.
Children differ greatly from adults in pathological changes

14. Types of diseases
 Congenital, hereditary and infectious diseases are much
more found among child patients.
 Congenital hypothyroidism, Congenital heart diseases
 Malignancy.
Dr kawir: MD, MPH, FGHR, MoTMID.

15. CLINICAL FEATURES :
Neonate with severe infection is always weak in
response, apathy, rejects feeding, but has neither
fever, nor increase in WBC counting or other
obvious clinical manifestations.
Dr kawir: MD, MPH, FGHR, MoTMID.

16. Diagnosis:
Varies with age.
Convulsion in children:
 Neonatal Period- obstetric injuries, asphyxia,
congenital diseases, intracranial hemorrhage.
 <6 mo. Old- intracranial infection, tetany of Vit D
deficiency.
 6 mo-3 yrs: high fever, intracranial infection
 > 3 yrs: epilepsy, intracranial tumor or fever, CNS
infection.
Dr kawir: MD, MPH, FGHR, MoTMID.

17. PROGNOSIS
 POSITIVE:
Children are more likely to recover after treatment from
bone fracture and acute infection with less sequela
occurrence.
 NEGATIVE:
Infants are vulnerable to certain acute severe diseases;
sudden death may happen. Such diseases include acute sepsis,
pneumonia, congenital malformation, foreign body in trachea,
and severe myocarditis.
Dr kawir: MD, MPH, FGHR, MoTMID.

18. Prevention:
Prevention in the health care of infants, children, and adolescents is
at the core of the field of pediatrics.
Planned immunization (vaccination) and supervision of infectious
diseases.
Neonatal screening tests can identify congenital hypothyroidism.
Treat urinary tract infection, acute nephritis to avoid the chronic
progress and renal dysfunction.
To prevent or reduce organ damage.
Dr kawir: MD, MPH, FGHR, MoTMID.

19. Stage of Children by Age & Principles of Health Care by
Age Stages.
Dr kawir: MD, MPH, FGHR, MoTMID.

20.  Fetal period
 Neonatal period
 Infant period
 Toddler age
 Preschool age
 School age
 Adolescence
Dr kawir: MD, MPH, FGHR, MoTMID.

21. From fertilized ovum formed to delivery (about 40 weeks).
Feature: easy abortion or malformation formed by any
risk factors.
Health care: pregnant woman and fetus.
Dr kawir: MD, MPH, FGHR, MoTMID.
FETAL PERIOD

22. Intrauterine life:
first trimester first 12 wk
second trimester 13 ～ 28wk
 third trimester 29 ～ 40wk
Dr kawir: MD, MPH, FGHR, MoTMID.
FETAL PERIOD

23. From umbilical ligation to 28th day after birth.
Features: beginning independent living.
The physiological regulation ability and adaptation to
circumstances are very poor.
The morbidity and mortality are very high.
Health care: enough nutrition
proper nursing care
prevention of diseases
Dr kawir: MD, MPH, FGHR, MoTMID.
NEONATAL PERIOD

24. Perinatal mortality is influenced by prenatal, maternal, and fetal
conditions and by circumstances surrounding delivery.
Diseases associated with preterm birth, low birth weight (LBW),
and intrauterine growth restriction (IUGR), such as placental
insufficiency, predispose the fetus to asphyxia, severe congenital
malformations, overwhelming early-onset neonatal infections .
Dr kawir: MD, MPH, FGHR, MoTMID.
NEONATAL PERIOD

25.  promoting optimal medical practices before, during,
and after delivery.
 Routine Delivery Room Care:
 Clear mouth and pharynx of fluid
 Antiseptic Skin and Cord Care
 Maintenance of Body Heat
 Breast- or bottle-feeds
Dr kawir: MD, MPH, FGHR, MoTMID.
NEONATAL PERIOD

26.  After delivery until 1 year-old
 Features:
Rapid growth period.
Fastest brain growth.
Nutrition and energy requirement are more.
Digestion and absorption functions are poor.
Passive immunity gradually drops.
 Health care: Enough nutrition
Prevention of diseases
Basic immunity
Dr kawir: MD, MPH, FGHR, MoTMID.
INFANT PERIOD

27. • From 1 to 3 year-old
• Features:
growth becomes slower
more vigorous, contact more objects.
intelligence develops faster
• Health care:
enough nutrition
Prevention of diseases
Prevention of accident
Dr kawir: MD, MPH, FGHR, MoTMID.
TODDLE AGE

28. • 3 years old until 6-7 years old
• Features:
growth becomes slower,
more mature intelligence.
strong desire for knowledge
imitating adult’s behavior
character forming.
• Health care:
enough nutrition
prevention of diseases
prevention of accident
a good habit training
Dr kawir: MD, MPH, FGHR, MoTMID.
PRESCHOOL AGE

29. SCHOOL AGE
• From 6-7 years old until adolescence
• Features:
growth becomes relatively steady
more mature intelligence develops
increasing desire for knowledge
decreasing incidence of diseases
• Health care:
enough nutrition
prevention of dental caries
prevention of problems in psychology,
emotion and behavior
Dr kawir: MD, MPH, FGHR, MoTMID.

30. • From 2nd sexual character appearing until sexual mature and
growth stopped .
--Girl: from 11-12 yrs to 17-18 yrs
--boy: from 13-14 yrs to 18-20 yrs
• Features: the second fastest period of growth and development
• Health care: enough nutrition
health care of adolescence
education
Dr kawir: MD, MPH, FGHR, MoTMID.

31. THANKS FOR YOUR ATTENTION
Dr kawir: MD, MPH, FGHR, MoTMID.