What is Tall Stature?
-The length or height is above 97th percentile or two standard deviations above the mean for normal population of same age, sex, region and race.
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-The length or height is above 97th percentile or two standard deviations above the mean for normal population of same age, sex, region and race.
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Causes for tall stature:
-Constitutional
-Cerebral gigantism
-Marfan's syndrome
-Sexual precocity
-Beckwith-Wiedemann syndrome.
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-Constitutional
-Cerebral gigantism
-Marfan's syndrome
-Sexual precocity
-Beckwith-Wiedemann syndrome.
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Remember:
-Primary microcephaly is present since birth and the causes are inherited.
-Secondary microcephaly occurs due to an insult to the growing brain, which results in deceleration or arrest of brain growth.
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-Primary microcephaly is present since birth and the causes are inherited.
-Secondary microcephaly occurs due to an insult to the growing brain, which results in deceleration or arrest of brain growth.
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Brachycephaly is seen in:
• Apert's syndrome
• Carpenter's syndrome
• Crouzon's syndrome
• Down's syndrome.
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• Apert's syndrome
• Carpenter's syndrome
• Crouzon's syndrome
• Down's syndrome.
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Severe perinatal asphyxia criteria according to American academy:
1. Apgar score <4 for 5minutes
2. Umblical artery PH<7
3. Neurological disorder as seizures
4. Multiorgan disorders.
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1. Apgar score <4 for 5minutes
2. Umblical artery PH<7
3. Neurological disorder as seizures
4. Multiorgan disorders.
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Causes of death in Marasmus:
1-Severe hypoglycemia
2-Shock "septic or dehydration"
3-Dehydration and electrolytes disturbance
4-Heart failure
5-Hypothermia
6-DIC
7-Infections especially pneumonia.
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1-Severe hypoglycemia
2-Shock "septic or dehydration"
3-Dehydration and electrolytes disturbance
4-Heart failure
5-Hypothermia
6-DIC
7-Infections especially pneumonia.
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-The term aseptic meningitis principally refers to viral meningitis, but meningitis with negative cerebrospinal fluid (CSF) bacterial cultures may be seen with other infectious organisms (Lyme disease, syphilis, tuberculosis).
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Remember:
-In older children, S. pneumoniae and N. meningitidis remain the most common causes of bacterial meningitis.
-Staphylococcal meningitis primarily occurs after neurosurgery or penetrating head trauma.
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-In older children, S. pneumoniae and N. meningitidis remain the most common causes of bacterial meningitis.
-Staphylococcal meningitis primarily occurs after neurosurgery or penetrating head trauma.
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Partially treated bacterial meningitis:
Pressure:
Normal or elevated1-10,000;
Cells:
PMNs usual but mononuclear cells may predominate if pretreated for extended period
Protein:
>100 mg/dl
Glucose:
Depressed or normal
Organisms may be seen; pre treatment may render CSF sterile but bacteria may be detected by PCR.
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Pressure:
Normal or elevated1-10,000;
Cells:
PMNs usual but mononuclear cells may predominate if pretreated for extended period
Protein:
>100 mg/dl
Glucose:
Depressed or normal
Organisms may be seen; pre treatment may render CSF sterile but bacteria may be detected by PCR.
#Pediatrics
UTI in first year is more common in males than females, why?
-Due to posterior urethral valve which exclusively occurs in males.
-But after that the incidence is more in females due to short and wide urethra.
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-Due to posterior urethral valve which exclusively occurs in males.
-But after that the incidence is more in females due to short and wide urethra.
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Remember:
-E.coli is the most common cause of UTI in children.
-Pseudomonas occurs especially in long standing catheterzation and neurogenic bladder.
-Klebsiella more in newborn.
-Adenovirus causes haemorrhgic cystitis.
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-E.coli is the most common cause of UTI in children.
-Pseudomonas occurs especially in long standing catheterzation and neurogenic bladder.
-Klebsiella more in newborn.
-Adenovirus causes haemorrhgic cystitis.
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Maternal risk factors of Birth asphyxia:
1-Hypertension
2-Eclampsia and preeclampsia
3-Diabetes Mellitus
4-Nephritis
5-Hypotension
6-Infection
7-Uterine tetany due to excessive oxytocin.
8-Maternal hypoxia
9-Elderly or young mothers
10-Antepartum and intrapartum anemia.
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1-Hypertension
2-Eclampsia and preeclampsia
3-Diabetes Mellitus
4-Nephritis
5-Hypotension
6-Infection
7-Uterine tetany due to excessive oxytocin.
8-Maternal hypoxia
9-Elderly or young mothers
10-Antepartum and intrapartum anemia.
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Maternal causes of IUGR:
1-Chronic illness like essential hypertension, pregnancy induced hypertension, chronic renal failure, DM and heart disease.
2-Young maternal age <18 years.
3-Poor maternal weight gain during pregnancy.
4-Fundal lag less 4 cm for gestional age.
5-Short stature.
6-Anemia.
7-Pre-pregnancy weight <50 kg.
8-Prior history of IUGR in a baby.
9-Multiple pregnancy.
10-Poor socioeconomic status.
11-Malnutrition of mother.
12-Smoking in mother.
13-Drugs "like phenytoin, valoprate).
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1-Chronic illness like essential hypertension, pregnancy induced hypertension, chronic renal failure, DM and heart disease.
2-Young maternal age <18 years.
3-Poor maternal weight gain during pregnancy.
4-Fundal lag less 4 cm for gestional age.
5-Short stature.
6-Anemia.
7-Pre-pregnancy weight <50 kg.
8-Prior history of IUGR in a baby.
9-Multiple pregnancy.
10-Poor socioeconomic status.
11-Malnutrition of mother.
12-Smoking in mother.
13-Drugs "like phenytoin, valoprate).
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Complications of hypothermia:
1-Hypglycemia, metabolic acidosis and hypoxia.
2-Clotting disorders: DIC and pulmonary haemorrhage.
3-Shock, decreased perfusion.
4-Intraventricular haemorrhage.
5-Apnea, severe sinus bradycardia and increased neonatal mortality.
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1-Hypglycemia, metabolic acidosis and hypoxia.
2-Clotting disorders: DIC and pulmonary haemorrhage.
3-Shock, decreased perfusion.
4-Intraventricular haemorrhage.
5-Apnea, severe sinus bradycardia and increased neonatal mortality.
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Criteria of Physiologic Jaundice:
It is a diagnosis of exclusion, having the following criteria:
1-It occurs in apparently healthy infants. "No pallor, organomegaly nor risk of kernicterus".
2-Clinical Jaundice appears after 24 hours of age, 2-3rd day in full term while 3-4th day in preterm.
3-Total bilirubin rises by less than 5mg/dl/day.
4-Peak bilirubin occurs at the 4th day"3-5 days" of age in term while in preterm its peak at 6th -8th day with a total bilirubin of no more than 12.9 mg/dl in term and more than 15mg/dl in preterm infant.
5-Clinical jaundice is resolved by 1 week in the term while 2 weeks in the preterm infant.
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It is a diagnosis of exclusion, having the following criteria:
1-It occurs in apparently healthy infants. "No pallor, organomegaly nor risk of kernicterus".
2-Clinical Jaundice appears after 24 hours of age, 2-3rd day in full term while 3-4th day in preterm.
3-Total bilirubin rises by less than 5mg/dl/day.
4-Peak bilirubin occurs at the 4th day"3-5 days" of age in term while in preterm its peak at 6th -8th day with a total bilirubin of no more than 12.9 mg/dl in term and more than 15mg/dl in preterm infant.
5-Clinical jaundice is resolved by 1 week in the term while 2 weeks in the preterm infant.
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