Paediatrics PDF

Paeds cardiology: ----------------- - Congenital HD: - Acyanotic causes: [VSD (most common)], ASD, PDA, Coarctation, A valve stenosis - Cyanotic(T): tetralogy, Transposition, Tricuspid atresia - **N.B [days-months following birth tetralogy \> transposi...

Paeds cardiology: ----------------- - Congenital HD: - Acyanotic causes: [VSD (most common)], ASD, PDA, Coarctation, A valve stenosis - Cyanotic(T): tetralogy, Transposition, Tricuspid atresia - **N.B [days-months following birth tetralogy \> transposition but at BIRTH transposition \> tetralogy ]** - General Fx: Poor feed, SOB, sweat, hepatomegaly - Manage (cyanotic): - Supportive + prostaglandin E1 (alprostadil) - Patent ductus arteriosus (PDA) open duct between pulmonary trunk and descending aorta (deoxy blood descending aorta) - Assoc premature, maternal rubella 1^st^ trimester - **[Continuous machine murmur]**, (AR fx) **collapsing pulse**, **wide pulse pressure**, - Manage: **[indomethacin/ibuprofen]** - **[If Assoc with another congenital HD operable]**, **[then prostaglandin E1 till surgery]** - Tetralogy of Fallot: - **VSD + RVH + Overriding aorta + pulmonary stenosis (RV outflow tract obstruction)** - **CFx:** - **Cyanosis (Tet spells** -- episodic cyanosis), - ej sys due to pulm stenosis, - R sided aortic arch, RL shunt, - CXR boot-shaped heart, ECG RVH - Manage: surg, b-blocks for cyanotic episodes - Transposition of the great arteries - Cfx: Cyanosis, tachypnoea, **Loud S2**, - CXR 'egg-on side' - Manage: **[prostaglandin to maintain ductus arteriosus]** until surgery - Innocent murmurs: - Venous hums: continuous blowing just below clavicles - Still's murmur: low pitch ↓L sternal edge (AP-**[T]**-M). - Characteristics: soft blowing in pulm area, short buzz in aortic area: - May vary w/ posture, - localised w/ no radiation, - no diastolic component, - no thrill, - no sounds, - asymptomatic, - no other abnormalities. - **Aortic stenosis in children (Cardiology)** - In children: William syndrome, coartaction, turner's - **In children, \>60mmhg balloon valvulo** - Hypertension in children (Cardiology) - Most common cause of 2ndary renal parenchymal disease - Others: phaemochromo, CAH, coarctation, renal vascular Paeds gastro: ------------- - Idiopathic constipation - After few weeks of birth, - \ - Septic arthritis in children - Commonly hip, knee, ankle - Fx: joint pain, limp, fever, system unwell (lethargy) - Signs: Swollen red joint, minimal move of affected joint - Ix: joint aspirate, inflame markers, BC - Kocher criteria to diagnosis septic arthritis: - Fever \38.5^o^C + non-weight bear + ↑ESR + ↑WCC - Slipped Capital femoral epiphysis - **10-15yrs**, obese - **FX:** pain (hip/groin/med-thigh/knee), ↓int rotation whilst flexed - **\^\^ n.**b can be B/L few times - IX: X-ray (AP + lateral frog leg) - Manage -- Internal fixation - Complication: OA, avasc femoral, Chondroly, leg-length disparaty - Transient synovitis: - Acute hip pain **following recent viral infection**, - **3-8 years age** - **[Fx]: limp/refuse to weight bear, groin-hip pain, +/- low grade fever** - **IF fever \38, refer to paeds specialist** Paeds surgical/vascular: ------------------------ - Kawasaki: - **FX: High-grade fever \>5days (resistant to antipyretics)** - **Strawberry tongue & cracked red-bright lips** - Cervical(neck) lymphadeno - Conjunctival injection - **Palms & sole red peels** - Clinical - Manage - Aspirin high dose, ALT IVIG & echocardio screen for [(**Coronary artery aneurysms)**] - Umbilical disorder: - Umbilical hernia -- Assoc: **premature** (spontane self), down's, mucopolsyacc stor disease, afro-carib - Paraumbilical -- (\1000/uL,** - **↑Csf WBC & protein \> 1g/L,** - **bacteria on gram stain** - **\