PEDIATRICS...
DIAGRAMS ARE NECESSARY
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1) MATERNAL INFECTIONS
Maternal infection is an infection acquired by the mother who then transmits the infection to the fetus. This transmission can occur via the placenta before delivery or via the birth canal during labor and delivery when the baby is exposed to maternal blood.
Maternal infections can occur at any stage of pregnancy, and can have serious implications for the fetus or soon-to-be newborn. Some of the most common maternal infections include:
Toxoplasmosis: Toxoplasmosis is an infection caused by exposure to Toxoplasma gondii, a single-celled parasite. Toxoplasmosis can be contracted by exposure to soil or feces, raw meat, or undercooked meat. The effects of toxoplasmosis on a fetus can be devastating, and may include physical or mental problems.
Chorioamnionitis: Chorioamnionitis is an infection of the placental tissues and amniotic fluid. Chorioamnionitis only occurs in two to four percent of full-term births, and is more likely in premature births. The causes of chorioamnionitis include E. coli and Group B streptococcus, and can lead to blood infection.
Bacterial Infections: Bacterial infections can include Group B streptococcal disease, Listeria, Salmonella, Syphilis, and Gonorrhea. These bacterial infections can result in premature birth, severe illness, miscarriage, deformity, or fetal death.
Viral Respiratory Infections: Common viral respiratory infections include Cytomegalovirus (CMV), Parvovirus, Varicella (chickenpox), and Rubella. Viral respiratory infections are particularly dangerous during early pregnancy and can lead to miscarriage, anemia, or birth defects. It is noted that CMV is a common cause of infant deafness; Parvovirus is a cause of congestive heart failure; and Rubella can lead to diabetes later in life.
2) GESTATIONAL DIABETES
Gestational diabetes is a condition in which your blood sugar levels become high during pregnancy. It affects up to 10% of women who are pregnant in the U.S. each year. There are two classes of gestational diabetes. Women with class A1 can manage it through diet and exercise
A form of high blood sugar affecting pregnant women.
Those who develop gestational diabetes are at higher risk of developing type 2 diabetes later in life.
In most cases, there are no symptoms. A blood sugar test during pregnancy is used for diagnosis.
Treatment strategies include daily blood sugar monitoring, a healthy diet, exercise and monitoring the baby. If blood sugar is too high, medication is required.
3) IMMUNIZATION SCHEDULE
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4) TYPES OF CEREBRAL PALSY
There are four major types of cerebral palsy: spastic, athetoid, ataxic and mixed type. The type of movement issues seen in a person with CP depends on how severely a brain injury has impacted muscle tone. Muscle tone is defined as the strength and tension of the muscles
Spastic Cerebral Palsy
Spastic cerebral palsy is the most common type of CP, making up 70 to 80 percent of cases. People with spastic cerebral palsy often experience exaggerated or jerky movements (hypertonia).
Spastic CP is caused by damage to the brain’s motor cortex, which controls voluntary movement. It is also caused by damage to the pyramidal tracts, which help relay signals to the muscles. This is why spastic CP is sometimes referred to as “pyramidal”.
Athetoid Cerebral Palsy
About 10 percent of children with cerebral palsy are diagnosed with athetoid CP, or “non-spastic CP”. This type of CP is characterized by a mixture of hypotonia and hypertonia, which causes muscle tone to fluctuate. The main trait of athetoid cerebral palsy is involuntary movement in the face, torso and limbs.
This type of cerebral palsy is caused by damage to the brain’s basal ganglia and/or cerebellum. The basal ganglia is responsible for regulating voluntary motor function and eye movements, while the cerebellum controls balance and coordination.
Ataxic Cerebral Palsy
Ataxia is a type of CP that causes problems with balance and coordination. Ataxic cerebral palsy makes up a small percentage of all cases. Those with ataxic CP typically have issues surrounding voluntary movement.
Ataxic cerebral palsy is different than other types of CP because it is primarily caused by damage to the cerebellum, which controls balance and coordination. People with ataxic CP often experience tremors and a reduction in muscle tone.
Mixed Cerebral Palsy
Sometimes damage to the developing brain isn’t confined to one location. In these circumstances, it is possible for a child to develop cerebral palsy that is characteristic of multiple brain injuries.
When a child is showcasing symptoms of more than one type of CP, it is considered to be mixed cerebral palsy. This diagnosis makes up less than 10% of all CP cases.
5) DUCHENNE MUSCULAR DYSTROPHY
An inherited disorder of progressive muscular weakness, typically in boys.
Many people with muscular dystrophy have Duchenne syndrome. Girls can be carriers and mildly affected, but the disease typically affects boys.
Symptoms include frequent falls, trouble getting up or running, waddling gait, big calves and learning disabilities.
There is no cure, but physiotherapy and medication, such as corticosteroids, can help control symptoms and improve quality of life.
Requires a medical diagnosis
Symptoms include frequent falls, trouble getting up or running, waddling gait, big calves and learning disabilities.
Treatment consists of steroid
There is no cure, but physiotherapy and medication, such as corticosteroids, can help control symptoms and improve quality of life.
6) BECKERS MUSCULAR DYSTROPHY
Becker muscular dystrophy (BMD) is an inherited condition that causes progressive weakness and wasting of the skeletal and cardiac (heart) muscles. It primarily affects males. The age of onset and rate of progression can vary. Muscle weakness usually becomes apparent between the ages of 5 and 15
Symptoms
The symptoms of Becker muscular dystrophy (BMD) may begin anywhere from childhood to a person's early 20s.[4][5] Muscle weakness often affects the legs and pelvis, and slowly gets worse.[4] Over time, affected people begin to have difficulty walking, frequent falls, difficulty with muscle skills (such as running, hopping, and jumping), and loss of muscle mass.[3] Eventually, affected people require a wheelchair.[5] The condition also affects the heart muscles, causing dilated cardiomyopathy. This form of heart disease enlarges and weakens the heart muscle, preventing it from pumping blood efficiently. Dilated cardiomyopathy progresses rapidly and is life-threatening in many cases.[4] Other symptoms of BMD may include cognitive problems, fatigue, loss of balance and coordination, problems breathing, and muscle weakness in the arms, neck and other areas of the body.[3]
7) SPINA BIFIDA
Spina bifida is a birth defect that occurs when the spine and spinal cord don't form properly. It's a type of neural tube defect. The neural tube is the structure in a developing embryo that eventually becomes the baby's brain, spinal cord and the tissues that enclose them
Types
Spina bifida can occur in different types: spina bifida occulta, myelomeningocele (my-uh-lo-muh-NING-go-seel) or the very rare type meningocele (muh-NING-go-seel).
Spina bifida occulta
"Occulta" means hidden. It's the mildest and most common type. Spina bifida occulta results in a small separation or gap in one or more of the bones of the spine (vertebrae). Many people who have spina bifida occulta don't even know it, unless the condition is discovered during an imaging test done for unrelated reasons.
Myelomeningocele
Also known as open spina bifida, myelomeningocele is the most severe type. The spinal canal is open along several vertebrae in the lower or middle back. The membranes and spinal nerves push through this opening at birth, forming a sac on the baby's back, typically exposing tissues and nerves. This makes the baby prone to life-threatening infections and may also cause paralysis and bladder and bowel dysfunction.
8) URINARY TRACT INFECTION
A urinary tract infection (UTI) is an infection of the urinary system. This type of infection can involve your urethra (a condition called urethritis), kidneys (a condition called pyelonephritis) or bladder, (a condition called cystitis).
Your urine typically doesn’t contain bacteria (germs). Urine is a byproduct of our filtration system—the kidneys. When waste products and excess water is removed from your blood by the kidneys, urine is created. Normally, urine moves through your urinary system without any contamination. However, bacteria can get into the urinary system from outside of the body, causing problems like infection and inflammation. This is a urinary tract infection (UTI).
The urinary tract makes and stores urine, one of the body's liquid waste products. The urinary tract includes the following parts:
Kidneys: These small organs are located on back of your body, just above the hips. They are the filters of your body — removing waste and water from your blood. This waste becomes urine.
Ureters: The ureters are thin tubes that carry urine from the kidneys to your bladder.
Bladder: A sac-like container, the bladder stores your urine before it leaves the body.
Urethra: This tube carries the urine from your bladder to the outside of the body.
9) MENINGOMYELOCELE
Meningomyelocele, also commonly known as myelomeningocele, is a type of spina bifida. Spina bifida is a birth defect in which the spinal canal and the backbone don't close before the baby is born. This type of birth defect is also called a neural tube defect.
A baby with meningomyelocele is born with the spinal cord exposed. A sac on the baby’s mid to lower back may cover the exposed spinal cord.
The exact symptoms and their severity depend on your child’s particular case. Meningomyelocele is often very severe, because the spinal cord has usually not developed properly and the brain is usually affected.
Abnormalities in the spinal cord often cause problems in leg, bladder, and bowel function. Some children might lose complete control of their bladder or bowel. Their legs may be partially or completely paralyzed or lack sensation. In other children, these body parts and their functions are only mildly affected.
Other possible symptoms include:
orthopedic deformities
hydrocephalus (buildup of fluid in the skull that leads to swelling of the brain)
Chiari malformation (structural defects in the part of the brain that controls balance)
Because the spinal cord is exposed, a child with meningomyelocele is at risk of developing bacterial meningitis.
10) HYDROCEPHALUS
Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain.[1] This typically causes increased pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes.[1]
Hydrocephalus can occur due to birth defects or be acquired later in life.[1] Associated birth defects include neural tube defects and those that result in aqueductal stenosis.[1][4] Other causes include meningitis, brain tumors, traumatic brain injury, intraventricular hemorrhage, and subarachnoid hemorrhage. The four types of hydrocephalus are communicating, noncommunicating, ex vacuo, and normal pressure. Diagnosis is typically made by physical examination and medical imaging.[1]
Hydrocephalus is typically treated by the surgical placement of a shunt system.[1] A procedure called a third ventriculostomy is an option in some people.[1] Complications from shunts may include overdrainage, underdrainage, mechanical failure, infection, or obstruction.[1] This may require replacement.[1] Outcomes are variable, but many people with shunts live normal lives.[1] Without treatment, death or permanent disability may occur.[1]
About one to two per 1,000 newborns have hydrocephalus.[1][3] Rates in the developing world may be higher.[5] Normal pressure hydrocephalus is estimated to affect about 5 per 100,000 people, with rates increasing with age.[6] Description of hydrocephalus by Hippocrates dates back more than 2,000 years.[5] The word hydrocephalus is from the Greek ὕδωρ, hydōr, meaning 'water' and κεφαλή, kephalē, meaning 'head'.[7]
11)DEFORMITIES IN CEREBRAL PALSY
Hip dislocation and ankle equinus or planter flexion deformity are the two most common deformities among children with cerebral palsy. Additionally, flexion deformity of the hip and knee can occur. Besides, torsional deformities of long bones such as the femur and tibia are encountered among others.
This deformity is often part of a larger lower extremity deformity. Specific foot deformities are:
Equinovarus (neuromuscular club foot) - foot points downwards and inwards.
Equinovalgus - foot points downwards and outwards.
Planovalgus (neuromuscular flat foot) - foot is flat and points out to the side.
Hallux valgus (neuromuscular bunion) - big toe points toward and sometimes under the second toe.
Pes Cavus - High arch generally seen in neuromuscular populations.
12) BACTERIAL INFECTIONS OF CENTRAL NERVOUS SYSTEM
There are a number of bacterial infections of the central nervous system (CNS), including meningitis, brain abscess, cranial and spinal epidural abscess, subdural empyema, and suppurative dural sinus thrombophlebitis, but this article focuses on the two CNS bacterial infections that neurologists encounter the most ...
Bacterial infections of the central nervous system (CNS) continue to be an important cause of morbidity and mortality in children. The spectrum of bacterial infection of CNS includes; focal or multifocal infections like brain abscesses or subdural empyema; or more generalized or diffuse infections like pyogenic meningitis or ventriculitis. Focal and generalized infections may co-exist in an individual patient. Prompt and adequate antibiotic therapy and occasionally neurosurgical interventions are the cornerstone of effective management. The recent emergence of several multidrug-resistant bacteria poses a threat to the effective management of bacterial CNS infections. Several adjunctive anti-inflammatory and neuroprotective therapies are being tried, however; none has made a remarkable impact on the outcome. Consequently, bacterial CNS infections in children still remain a challenge to manage. In this review, authors discuss the current updates on the diagnostic and therapeutic aspects of bacterial infections of the CNS in children (post-neonatal age group).
13) LUNG ABCESS
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm)[1] containing necrotic debris or fluid caused by microbial infection.
This pus-filled cavity is often caused by aspiration, which may occur during anesthesia, sedation, or unconsciousness from injury. Alcoholism is the most common condition predisposing to lung abscesses.
Lung abscess is considered primary (60%[2]) when it results from existing lung parenchymal process and is termed secondary when it complicates another process e.g. vascular emboli or follows rupture of extrapulmonary abscess into lung.
Conditions contributing to lung abscess
Aspiration of oropharyngeal or gastric secretion
Septic emboli
Necrotizing tumors: 8% to 18% are due to neoplasms across all age groups, higher in older people; primary squamous carcinoma of the lung is the most common.
Organisms
In the post-antibiotic era pattern of frequency is changing. In older studies anaerobes were found in up to 90% cases but they are much less frequent now.[5]
14) BRONCHIAL ASTHMA
Condions contributing to lung abscess
Aspiration of oropharyngeal or gastric secretion
Septic emboli
Necrotizing tumors: 8% to 18% are due to neoplasms across all age groups, higher in older people; primary squamous carcinoma of the lung is the most common.
Organisms
In the post-antibiotic era pattern of frequency is changing. In older studies anaerobes were found in up to 90% cases but they are much less frequent now.[5]
15) BRONCHIECTASIS
Bronchiectasis is a disease in which there is permanent enlargement of parts of the airways of the lung.[5] Symptoms typically include a chronic cough with mucus production.[3] Other symptoms include shortness of breath, coughing up blood, and chest pain.[2] Wheezing and nail clubbing may also occur.[2] Those with the disease often get frequent lung infections.[8]
Bronchiectasis may result from a number of infectious and acquired causes, including pneumonia, tuberculosis, immune system problems, as well as the genetic disorder cystic fibrosis.[11][3][12] Cystic fibrosis eventually results in severe bronchiectasis in nearly all cases.[13] The cause in 10–50% of those without cystic fibrosis is unknown.[3] The mechanism of disease is breakdown of the airways due to an excessive inflammatory response.[3] Involved airways (bronchi) become enlarged and thus less able to clear secretions.[3] These secretions increase the amount of bacteria in the lungs, resulting in airway blockage and further breakdown of the airways.[3] It is classified as an obstructive lung disease, along with chronic obstructive pulmonary disease and asthma.[14] The diagnosis is suspected based on symptoms and confirmed using computed tomography.[7] Cultures of the mucus produced may be useful to determine treatment in those who have acute worsening and at least once a year.[7]
Periods of worsening may occur due to infection.[8] In these cases, antibiotics are recommended.[8] Common antibiotics used include amoxicillin, erythromycin, or doxycycline.[15] Antibiotics, such as erythromycin, may also be used to prevent worsening of disease.[3][16] Airway clearance techniques, a type of physical therapy, are also recommended.[17] Medications to dilate the airways and inhaled steroids may be used during sudden worsening, but there are no studies to determine effectiveness.[3][18] There are also no studies on the use of inhaled steroids in children.[18] Surgery, while commonly done, has not been well studied.[19][3] Lung transplantation may be an option in those with very severe disease.[9]
16) CLASSIFY VITAMINS
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SHORT ANSWERS
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1) RICKETS
A softening and weakening of bones in children, usually due to inadequate vitamin D.
Lack of vitamin D results in reduced absorption of calcium and phosphorus. Difficulty maintaining proper calcium and phosphorus levels in bones can cause rickets.
Symptoms include delayed growth, bow legs, weakness and pain in the spine, pelvis and legs.
Treatment includes exposure to sunlight, a diet rich in vitamin D and calcium, supplements, medication or possibly surgery.
2) OSTEOMALACIA
Osteomalacia refers to a marked softening of your bones, most often caused by severe vitamin D deficiency. The softened bones of children and young adults with osteomalacia can lead to bowing during growth, especially in weight-bearing bones of the legs. Osteomalacia in older adults can lead to fractures.
Treatment for osteomalacia involves providing enough vitamin D and calcium, both required to harden and strengthen bones, and treating disorders that might cause the condition.
3) SCURVY
Scurvy is a disease resulting from a lack of vitamin C (ascorbic acid).[1] Early symptoms of deficiency include weakness, feeling tired and sore arms and legs.[1][2] Without treatment, decreased red blood cells, gum disease, changes to hair, and bleeding from the skin may occur.[1][3] As scurvy worsens there can be poor wound healing, personality changes, and finally death from infection or bleeding.[2
4) ANAEMIA
Anemia (also spelled anaemia) is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood,[3][4] or a lowered ability of the blood to carry oxygen.[5] When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath, and a poor ability to exercise.[1] When the anemia comes on quickly, symptoms may include confusion, feeling like one is going to pass out, loss of consciousness, and increased thirst.[1] Anemia must be significant before a person becomes noticeably pale.
5) HYPERTHYROIDISM
A condition in which the thyroid gland doesn't produce enough thyroid hormone.
Hypothyroidism's deficiency of thyroid hormones can disrupt such things as heart rate, body temperature and all aspects of metabolism. Hypothyroidism is most prevalent in older women.
Major symptoms include fatigue, cold sensitivity, constipation, dry skin and unexplained weight gain.
Treatment consists of thyroid hormone replacement.
6) BRONCHIAL ASTHMA
A condition in which a person's airways become inflamed, narrow and swell and produce extra mucus, which makes it difficult to breathe.
Asthma can be minor or it can interfere with daily activities. In some cases, it may lead to a life-threatening attack.
Asthma may cause difficulty breathing, chest pain, cough and wheezing. The symptoms may sometimes flare up.
Asthma can usually be managed with rescue inhalers to treat symptoms (salbutamol) and controller inhalers that prevent symptoms (steroids). Severe cases may require longer-acting inhalers that keep the airways open (formoterol, salmeterol, tiotropium), as well as inhalant steroids.
7) BIRTH ASPHYXIA
Perinatal asphyxia (also known as neonatal asphyxia or birth asphyxia) is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. It is also the inability to establish and sustain adequate or spontaneous respiration upon delivery of the newborn. It remains a serious condition which causes significant mortality and morbidity. It is an emergency condition and requires adequate and quick resuscitation measures.
8) PRESSURE SORES
Injury to skin and underlying tissue resulting from prolonged pressure on the skin.
People most at risk are those with a condition that limits their ability to change positions.
Bed sores often develop on the heels, ankles, hips and tailbone. They can develop quickly.
Bed sores can be difficult to treat. Treatment includes cleaning and dressing the wound along with reducing pressure on the sore by frequent changes in position.
9) MENTAL RETARDATION
Intellectual disability (ID), once called mental retardation, is characterized by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. People with intellectual disabilities can and do learn new skills, but they learn them more slowly.
Below average intelligence and set of life skills present before age 18.
Intellectual function can be measured with a test.
The main symptom is difficulty thinking and understanding. Life skills that can be impacted upon include certain conceptual, social and practical skills.
Special education and behavioural therapy can help a person live to his or her fullest.
10) STILLS DISEASE
Still's disease, a disorder featuring inflammation, is characterized by high spiking fevers, salmon-colored rash that comes and goes, and arthritis. Still's disease is also referred to as systemic-onset juvenile idiopathic arthritis. Still's disease was first described in children, but it is now known to occur, much less commonly, in adults (in whom it is referred to as adult-onset Still's disease or AOSD).
11) SPINA BIFIDA
A birth defect in which a developing baby's spinal cord fails to develop properly.
It occurs when a developing baby's spinal cord fails to develop or close properly while in the womb.
Symptoms can sometimes be seen on the skin above the spinal defect. They include an abnormal tuft of hair, a birthmark or protruding spinal cord tissue.
When treatment is necessary, it's carried out through surgery to close the defect. Other treatments focus on managing complications.
12) MENINGOMYELOCELE
Meningomyelocele, also commonly known as myelomeningocele, is a type of spina bifida. Spina bifida is a birth defect in which the spinal canal and the backbone don't close before the baby is born. This type of birth defect is also called a neural tube defect.
13) CLINICAL FEATURESOF URINARY TRACT INFECTION
Usually self-diagnosable
A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine. A kidney infection may cause back pain, nausea, vomiting and fever.
Pain areas: in the bladder, groin, lower abdomen, or pelvis
Pain circumstances: can occur during urination or during sexual intercourse
Urinary: foul smelling urine, frequent urination, bladder spasm, cloudy urine, dark urine, persistent urge to urinate, sense of incomplete bladder emptying, or blood in urine
Whole body: fatigue, fever, or malaise
Also common: cramping or vaginal irritation
14) SURGICAL MANAGEMENT OF HYDROCEPHALUS
The most common treatment for hydrocephalus is the surgical insertion of a drainage system, called a shunt. It consists of a long, flexible tube with a valve that keeps fluid from the brain flowing in the right direction and at the proper rate. One end of the tubing is usually placed in one of the brain's ventricles
15) MICROCEPHALY
A condition in which a baby's head is significantly smaller than expected, often due to abnormal brain development.
Causes of microcephaly include infections, malnutrition or exposure to toxins.
Symptoms vary and include intellectual disability and speech delay. In severe cases, there may be seizures and abnormal muscle functionality.
There is no cure for microcephaly. Treatment involves supportive care, symptom management and close monitoring.
16) DEFINE CEREBRAL PALSY
A congenital disorder of movement, muscle tone or posture.
Cerebral palsy is due to abnormal brain development, often before birth.
Symptoms include exaggerated reflexes, floppy or rigid limbs and involuntary motions. These appear by early childhood.
Long-term treatment includes physical and other therapies, drugs and sometimes surgery.
17) ORAL POLIO
A virus that may cause paralysis and is easily preventable by the polio vaccine.
Polio is transmitted through contaminated water or food, or contact with an infected person.
Many people who are infected with the poliovirus don't become sick and have no symptoms. However, those who do become ill develop paralysis, which can sometimes be fatal.
Treatment includes bed rest, pain relievers and portable ventilators.
18) MATERNAL INFECTIONS
Maternal infection is an infection acquired by the mother who then transmits the infection to the fetus. This transmission can occur via the placenta before delivery or via the birth canal during labor and delivery when the baby is exposed to maternal blood