Note

•Adult remnants of fetal circulation includes:

1- Umbilical vein = Ligamentum teres
2- Ductus venosus = Ligamentum venosus
3- Foramen Ovale = Fossa cialis
4- Umbilical arteries = Proximal part contribute to the internal iliac arteries and superior vesical arteries whereas the distal parts collapse and become fibrotic forming the medial umbilical ligaments.
5- Ductus arteriosus= Ligamentum arteriosum or Harvey's ligament.

#Surgery

Remember:

-The term malnutrition is used to denote undernutrition, overnutrition and selective nutritional deficiencies.

However, the terms malnutrition, PEM and undernutrition are often used interchangeably.

-Undernutrition occurs due to inadequate intake, poor absorption or excessive loss of nutrients.

-Overnutrition occurs due to excessive intake of nutrients.

#Pediatrics

Obesity is a condition with exceas amount of body fat.
-There is an increase in the number and size of adipocytes.

-A child whose weight for age is between 110% and 120% of the standard weight is known as overweight.

-While that more than 120% of the
standard weight is obese.

#Pediatrics

Remember:

-PDD "Postdiarrheal abdominal distension"
It occurs as a complication after diarrhea due to hypokalemia, paralytic ilius.


#Pediatrics

Subacute sclerosing panencephalitis:

-It is a rare form of chronic progressive brain inflammation caused by slow infection with certain defective strains of hypermutated measles virus.

-Cause: Measles virus.

-Usual onset: 6-20 years after infection with measles.
-Frequency: About 1 in 10,000 people infected by measles.
-Symptoms: Behavior changes, seizures, spasticity, poor coordination,ataxia, coma.
-It's also divided into 4 stages
-Diagnostic: EEG, Serologic testing, brain biopsy.
-Prevention:
Measles vaccine
-Treatment:
Supportive treatment,
Intrathecal interferon alpha, intravenous ribavirin.
-Prognosis: usually fatal.

#Pediatrics

Causes of Pneumonia according to age.
#Pediatrics

Bacterial pneumonia vs Viral pneumonia.

#Pediatrics

Splinter haemorrhage:

It is not a specific sign of infected endocarditis

D.D:
Trauma...is the most common cause
Infective endocarditis.
Subungual haematoma.
Hemophilia.
Leukemia.
Meylobleroprative disorders.
Vasculitis.
DIC.
SLE.
Sepsis.

#Medicine

Respiratory rate and tachypnoea.

#Pediatrics

Cardiac cyanosis vs Respiratory cyanosis.

#Pediatrics

Role of QRS complexes in ECG diagnoses:

A-LVH
B-Dextrocardia or limb leads reversal
C-STEMI
D-HOCM
E-RBBB
F-LVH e Strain
G-Pacing Rhythm
H-LBBB
I-WPW
J-RVH e Strain.

#Medicine

Investigations in case of SCD:

•CBC:
-Low Hb, low Ht value
-Normocytic normochromic anemia,
Leukocytosis is common.
-Evidence of hemolysis:
Reticulocytosis- increased erythropoiesis
↑Unconjugated bilirubin
↑Fecal sterobilonogin
↑LDH
↑Urinary urobilinogen.

•Blood film:
-Crescent-shaped sickled RBCs ; sickle cells
-Howell-Jolly bodies

•Skull x-ray :
-May show hair-on-end (“crew cut”) sign

•Hemoglobin electrophoresis:
-Shows 80-99% HbS, HbF may be elevated 2-10%.
-This test confirms the diagnosis.
Note: The HbA2 is not increased, (unlike beta-thalassemia in which HbA2 is increased).

•Prenatal:
-By CVS "chorionic villous sampling" and DNA analysis.

#Pediatrics

Vaccines.

إختبار الأطفال -الدفعتين 18&19-سادسة

Essay Questions

1-Treatment and prevention of:
A-Tetanus
B-Diphtheria.
2-Clinical features and diagnosis of:
A-Poliomyelitis
B- Measles.
3-Write about:
A-Types and clinical presentation of Focal seizures.
B-Febrile seizures, definition ,types and risk factors for occurrence of subsequent epilepsy.
4-Enumrate five Congenital heart diseases and discuss briefly one of them.
5-Mention five features of Turner syndrome.
6-Clinical manifestations of Hemophilia A.
7- Definition and causes of Kwashiorkor.
8-Early manifestations of Rickets and radiologic findings in active rickets.
9-Diagnosis and complications of Rheumatic fever.
10-Causes of Short stature.
11-Calculate a formula feeding for a 4 month-old infant of a mother with heart failure including number of feeds daily and amount per feed.
12-Write in details the clinical features and treatment of Type I Diabetes mellitus.

+40 MCQ's

Best wishes.✨

Calculate a formula feeding for a 4 month-old infant of a mother with heart failure including number of feeds daily and amount per feed.

بما أن الأم معها  heart failure يعني indication للـ Substitutive feeding.

معروف أن:
Number of feeds in Substitutive feeding is 6 feeding per day.
So:
Number of feed= 6 feeds/ day.

ذلحين نحسب الـ  Amount per feed،في طريقتين:
-Age method which is simple,used in healthy infants with appropriate weight for age.
100+(10× age by months)
In above case age is 4 m.
So = 100+(10×4) → 100+40 =140 ml

-Weight method,which is more accurate used in healthy and diseased infants.

As it's known that infant needs 25 ml/kg /feed, and his weight is 6 kg → 25 × 6= 150 ml /feed.


بإختصار:
-Number of feeds =6 feeds /day
-Amount per feed= 150 ml =5 scoops +150ml water.
-Interval of feed: 4hourly interval.

الخمسة هي الملاعق الحليب لكل ١٥٠ مل ماء؛ لأن كل ملعقة ٣٠ مل.

طريقة النجار وأبو الأسرار.

طريقة ثانية، عن طريق الـ calories.