This document provides information on various pediatric medical conditions organized into sections on nutritional deficiencies, rheumatology, genetic syndromes, radiology, ECGs, endocrinology, and miscellaneous topics. Key conditions discussed include Down syndrome, tuberculosis, croup, hypothyroidism, rickets, craniosynostosis, and allergic rhinitis. Diagnostic features, treatments, and complications are outlined for many common pediatric diseases and disorders.
Dnb pediatrics osce 2 for PGS in Southern Railway HospitalNibedita Mitra
DNB pediatrics Osce for Post graduates in southern Railway Head Quarter Hospital. This includes a video Station. Click on the picture to play the video
Practical pediatric quiz - Kaun Banega WinnerGaurav Gupta
Interactive quiz based on mentimeter platform for IAP Chandigarh Annual meeting in Dec 2017.
Great success for practising paediatricians in general,
Also a great teaching experience
Dnb pediatrics osce 2 for PGS in Southern Railway HospitalNibedita Mitra
DNB pediatrics Osce for Post graduates in southern Railway Head Quarter Hospital. This includes a video Station. Click on the picture to play the video
Practical pediatric quiz - Kaun Banega WinnerGaurav Gupta
Interactive quiz based on mentimeter platform for IAP Chandigarh Annual meeting in Dec 2017.
Great success for practising paediatricians in general,
Also a great teaching experience
PREMATURE AGING SYNDROMES AND THEIR CLINICAL MANIFESTATIONSDR. MOHNISH SEKAR
Aging is an inevitable consequence of human life resulting in a gradual deterioration of cell, tissue and organismal function and an increased risk to develop chronic ailments. Premature aging syndromes, also known as progeroid syndromes, recapitulate many clinical features of normal aging and offer a unique opportunity to elucidate fundamental mechanisms that contribute to human aging. Progeroid syndromes can be broadly classified into those caused by perturbations of the nuclear lamina, a meshwork of proteins located underneath the inner nuclear membrane (laminopathies); and a second group that is caused by mutations that directly impair DNA replication and repair.
Please find the power point on Brainsteam stroke. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
PRESENTATION IS COMPACT AND INFORMATIVE. HAS FLOWCHARTS AND DIAGRAMS. REFERENCE IS FROM LATEST ARTICLES AND STANDARD TEXTBOOKS. SERVES A GREAT DEAL TO BRUSH UP THE THEORETICAL KNOWLEDGE .
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
15. Trisomy 18 (Edward’s Syndrome)
•2nd most common trisomy
•MR, Hypertonia, small faces, clenched hands, rocket bottom feet. Survival ~ 1
year
16. Patu Syndrome (Trisomy 13)
•Mid-line defects
•Severe MR, colobomas, microophthalmia
•Cleft lip palate
•Prognosis is poor, dead within the 1st month of life
17. Turner Syndrome
•Incidence: 1:2000
•Short webbed neck, short stature, broad chest, swelling of hand and foot,
ovarian dysgenesis, horse-shoe kidney, Bicuspid aortic valve and
coarctation of aorta
18. Fragile X –Syndrome (Martin-Bell
Syndrome)
•X-linked caused by CGG repeat, trinucelotide repeat. Its more severe in male. Most
common inherited cause of MR
•Incidence 1:1250 in males and 1:2500 females
•Mild to severe MR, Large ears, macocephaly
•Large testes, autism, ADHD, diagnosis by chromosomal analysis
20. Klinefelter Syndrome
•XXY
•Most common cause of male hypogonadism and infertility, increased risk with maternal
age
•Incidence 1:500 male births !!!
•Tall with tall extremities, hypogonadism with delayed puberty, gynecomastia, variable
intelligence, antisocial
21. Fetal Alcohol Syndrome
IUGR, FTT, Microcephaly, long smooth philtrum,
Smooth upper lip, MR, Hyperactivity and VSD
22. Osteogenesis Imperfecta
•AD. Defect in type I Collagen
•Blue sclera, fragile bones, yellow-blue teeth, easy bruising
•Diagnosis: clinical features + low collagen type 1 in fibroblast
•Complications: hearing loss, skeletal deformities, genu valgum (knocked-knee)
23. Williams Syndrome
•Deletion on chromosome 7 AD. Gene for elastin
•Elfin faces: short palpebral fissure, flat nasal bridge and round cheeks
•Mental retardation
•Aortic stenosis
•Hypercalcemia in infancy
•Diagnosis: FISH
24. Cornelia De Lange Syndrome
•Inheritance is mostly sporadic but can be AD
•Single eye bow, microcephaly, micrognathia
•Short stature
•Infantile hypertonia & Mental retardation
•Cardiac problems
25. Cornelia De Lange Syndrome
SGA, Micrognathia, hypertonia, microcephaly, MR, Cardiac defects
Sporadic or AD
28. Cri-Du-Chat
•Partial deletion on the short arm of chromosome 5 sporadic.
•Microcephaly, downslanting palpebral fissure, cat like cry
•Mental retardation
29. Wolf Hirschhorn Syndrome
•Results from the deletion of the short arm of
chromosome 4
•Craniofacial: microcephaly, micrognathia and
short philtrum, dysplastic ears and periauricular
tags
•Neuro: growth retardation, hypotonia, seizures
•CHD
•Antibodies: deficiency of IgA
30. Prune Belly Syndrome
• A partial or complete lack of abdominal wall
muscles. There may be wrinkly folds of skin
covering the abdomen.
• Cryptorchidism (undescended testicles) in males
• Urinary tract abnormality such as unusually
large ureters, distended bladder, accumulation
and backflow of urine from the bladder to the
ureters and the kidneys (vesicoureteral reflux)
• Frequent urinary tract infections due to the
inability to properly expel urine.
• Ventricular septal defect
• Malrotation of the gut
• Club foot
• Later in life, a common symptom is post-
ejaculatory discomfort. Most likely a bladder
spasm, it lasts about two hours.
• Musculoskeletal abnormalities
32. Sturge Weber Syndrome
•Sporadic disorder with a port-wine stain in the distribution of the trigeminal nerve
associated with a lesion intracranially. The ophthalmic deviation of the V nerve is always
involved
•Intracranial calcification on skull X-ray
•Can result in epilepsy, MR and hemiplegia. High risk of glaucoma!!
35. Hurler Syndrome
Mucopolysaccharidosis autosomal disease
Baby present with developmental delay, hepatosplenomegaly with coarse facial features
Death is common in childhood as a result of respiratory/pulmonary compromise
37. Achondroplasia
It is the most common genetic form of skeletal dysplasia. Prominent
forehead, stubby fingers, lumbar lordosis and intelligence is normal
Complications: hydrocephalus, apnea and sudden death 2ry to bony over
growth at foramen magnum
57. Kartagener Syndrome (AR)
Immotile Cilia Syndrome
•Dyfunctional cilia resulting in abnormal airway clearance.
•Patients with KS will have (Situs inversus, chronic sinusitis, otitis media and airway
disease) – they usually have a normal life span
66. Retropharyngeal Abscess
•Infection between the posterior
pharyngeal wall and the prevertebral
fascia results in a retrophryngeal
abscess. The most common organisms
are S. aureus and GABS
•History of pharyngitis, fever, sore
throat, drooling
•Rx: incision and drainage
77. Supraventricular Tachycardia
•Rate ~ 250 bp/min
Management:
•Vagal stimulation: ice-pack to face, unilateral carotid massage, place child upside
down, pressure in the orbit convert it to sinus tachycardia
•IV adenosine: to convert it to sinus rhythm
•Chronic medical Rx: digoxin, propanolol,
•Radiofreq catheter ablation: to destroy the accessory pathway.
83. 2nd Degree Heart Block
(Mobitz-I)
Progressive lengthening of the PR wave until we skip a QRS (skip a beat),
usually asymptomatic
84. 2nd Degree Heart Block
(Mobitz-II)
PR is the same will not lengthen just a sudden drop in the beat
85. 3rd Degree Heart Block
Complete Block of the AV Node (No Conduction
From Atrium to Ventricle)
Atria and ventricle beats independently of each other
Caused by maternal SLE
86. ETIOLOGY of Heart Block
•Post surgical AV block
•Bacterial endocarditis can result in AV block
•Clinical features: syncope, fatigue, sudden death
•Rx: Pacemaker for symptomatic AV block
90. Hyperkalemia
Hyperkalaemia is defined as a potassium level > 5.5 mEq/L
Moderate hyperkalaemia is a serum potassium > 6.0 mEq/L
Severe hyperkalaemia is a serum potassium > 7.0 mE/L
103. Ectopic Thyroid Gland
•One of the causes of congenital
Hypothyroidism accounting for
1/3 of cases of
•Thyroid dysgenesis (90% of
congenital hypothyroidism)
116. Ataxia Telangictesia
It’s an autosomal recessive disorder
Problems with DNA repair
1- Ataxia
2-Low IgA
3- Increased risk of ALL 10%
4- High serum alfa-feto-protein
117. Gray Baby Syndrome
Gray baby syndrome = chloramphenicol toxicity
Inability to metabolize the drug due to reduced
activity of the enzyme UDGT (Glucoronyl
Transferase) in neonates (especially premature)
123. Heel Prick Test
Usually done at day 5, it’s a screening test for:
•Galactosemia
•Immunoreactive trypsinogen to detect cystic fibrosis.
•Maple syrup urine disease
•MCADD
•PKU
•SCD
•Congential hypothyroidism
129. Cradle Cap
•Greasy, yellow scaly patches over the scalp
•May spread to face, ear and nappy area(infantileSeborrheic dermatitis )
•Possibly due to overactive sebaceous glands in the skin of newborn babies
•Not itchy (NO pruritis)
•Treatment with mild baby shampoos. Wash regularly and brush softly to remove
scales
•Baby oil can help soften scales (not olive oil!)
•Resolves by 6-12mths
•If fails to improve = Try topical steroids+/- antifungal
133. Chickenpox
•Begins as an itchy red papules progressing to vesicles on bright red base (dew
drops on a rose petal) on the stomach, back and face, and then spreading to other
parts of the body
•Central umbilication of blisters follows rapidly, crusting and desquamation
within 10 days
•Fever, sore throat, anorexia, malaise may precede rash by several days
•Incubation 7-21 days
•Symptomatic treatment in immunocompetent
• Cool compress, calamine lotion, antihistamines
134.
135. Measles
•Prodrome; fever, malasie, dry cough, coryza,
conjunctivitis, photophobia
•Koplik spots on buccal mucosa
•Rash 3-4th day of illness
•Starts on face as blanching red macules and
papules, non itchy
•Spreads down trunk and extremities
•Rash coincides with high fever
•Lesions become confluent, older lesions develop
rusty hue
•Contagious 4 days before rash and 4 days after
136. Roseola Infantum
•Also called exanthema subitum or sixth
syndrome
•Herpes virus 6
•High fever followed by macular rash
•Mild cervical lymph nodes
•MIS-diagnosed as measles or rubella
•Diagnose by serology
•Treat symptomatic
137. Erythema Infectiosum
•Also called Slapped cheek syndrome or Fifth
disease
•Caused by parvovirus 19
•Young school aged children
•Usually asymptomatic
•Aplastic crisis in haemolytic anaemias(Sickle cell
/ Thalasemia)
•In pregnancy –fetal complications
139. Atopic Eczema (Atopic Dermatitis)
Infants
◦ Infants less than one year old often have widely distributed eczema.
◦ The skin is often dry, scaly and red with small scratch marks made by sharp
baby nails
◦ The cheeks of infants are often the first place to be affected by eczema.
◦ Readly infected with Staph or Strep or rarely herpes
140. Ahealthy 6 yr old boy had developed multiple papules on arm.leg ,trunk
What is the lesion ?
141. MOLLUSCUM CONTAGIOSUM
•Common in school children with DNA pox virus
•Spread by contact and scratching lesions
•PEARLY Papule with cental UMBLICUS
•Spontaneous resolution in 6-9 mo(can last years)
•Advise to separate Towels and Bath
•Occasional Treated by CRYOTHERAPY
142. A2 yr old girl is seen in HC with diffuse intense itching.All family member
are itching-Interdigital lesion , papulovesicle
What is the lesion?
143. SCABIES
•An irritative reaction to female mite Sarcoptes scabiei
•Transmission by direct contact
•Scabies Burrows/Rash
•Widespread itchy reaction to mite,their egg and excreta after 4-6 wk
•Erythematous papule,pustule,excoriation
•Lab Diagnosis by removal of mite or egg by KOH soln over a burrow, scraping with
needle and see under MICROSCOPE
Treatment
• Treat patient and all close contact
• Topical Scabicide: Permethrin cream after a bath to whole body(and Head <2 yr)
• Wash all bed linen and immediate clothes
144. A6 yr old boy had painful nodular lesion after sore throat over the shin
What is the lesion?
145. Erythema Nodosum
•Painful shinny,hot red elevated oval nodule over the shin, female>male
Causes:
• Infection: Strep,Mycoplasma,TB
• IBD: Crohn , Ulcerative colitis
• Autoimmune: Sarcoidosis, SLE
• Drugs: Sulphonamides,oral contraceptive
•Treament: bed rest, NSAID, treat the cause
146. Umblical (UH) & Inguinal Hernia (IH)
UH
•Common in afro-Caribbean
•May increase in size in first few month
•Not painful, not tender, easily reducible
•Most disappear by 1 year
•Consider hypothyroidism (Cretin)
•Refer for surgery if persist by 4 yr
IH- an emergency-Refer to Surgeon
147. Gastroschisis
•Opening in an abdominal wall present to the right to the umbilicus
•Often diagnosed on prenatal ultrasound
•Managed by placement of plastic bag followed by surgical repair
148. Ambiguous Genitalia
Congenital Adrenal Hyperplasia (CAH)
•CAH most common cause of ambiguous genitalia
•21-Hydroxylase deficiency is the most common
•Investigations:karyotype, serum electrolyte, abdominal
ultrasound & hormone assay
Management:
•Replace hormone (cortisol/testosterone)+
reconstructive surgery
151. Achondroplasia
•Autosomal dominant
•Most common skeletal dysplasia
•Short stature, macrocephaly,flat midface with
prominent forehead
•Associated hydrocephalus,dental
malocclusion,hearing loss
•Normal intelligence and normal life spans
153. Supra-Ventricular Tachycardia
•Most common arrhythmia in children's
•Narrow QRS complex ,difficult to find P wave.
•Heart rate >200 usually idiopathic-Rarely Wolff-Parkinson syndrome
•Vagal stimulation—carotid sinus message,cold ice pack to face
•I/V adenosine if stable and not in shock
•Synchronised DC shock if in shock?
157. AeroChamber with Mask
•Used in Children for delivery of drugs in Asthma (inhaled steroids/ventolin) with
inhalor.
•Better coordination and deposition of drugs in lung in small Kids
Autosomal dominant disorder charactrized by the paucity of the intrahepatic bile duct and multiorgan involvement
2/3 of patients have abnormality on chromosome 20
Clinical features:
1-cholestatic liver disease
2-faces; broad forehead, wide spaced eyes, saddle nose with bulbous tip, pointed chin and large ears
3-cardiac: pulmonary outflow obstruction
4-renal anomalies
5-eye anomalies
6- butterfly verterbrae and broad thumb
7-FTT and short stature
8-pancreatic insufficieny
9-hypercholsterolemia
Management is supportive
Autosomal dominant with variable penetrance
Hyperplasia of the brow, broad nasal bridge, partial albinism and deafness