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.

Classification of diarrhea according of Duration and etiology .. and 10 kg beby with sever dehydration what is management.

It is management in hospital.

1-Addmision
2-Intravenous rehydration: within 24 hrs.
Shock therapy:
-Amount: 20 ml/kg I.V infusion over 10-15 minutes.
20×10= 200ml
-Type of solution: Ringer’s lactate or NS if Ringer’s lactate not available.

Deficit therapy:" over 8 hrs"
-Amount: 80 ml / kg, because we had given shock therapy.
80×10 =800ml /8
-Type of solution: D5% NS 1:1.
-Add KCL 15 % in amount of 1 ml for each 100 ml solution.

Maintenance therapy:

Amount: 100 ml/kg for first 10 kg.
100×10= 1000ml
Type of solution: D5% NS 4:1.
Add KCL 15 % in amount of 1 ml for each 100 ml solution.


Next 24 hrs
If fully hydrated:
Half maintenance given IV
Other half of maintenance given as ORS.

Fully hydrated, but continuous severe diarrhea:
Give maintenance therapy plus ongoing loss.

If Still dehydrated repeat dificit and maintenance.

3-Treatment of complications:
AKI
Sepsis
Metabolic acidosis
.. etc.

How to calculate OL:

Ongoing loss: Number of motion:
Ongoing loss=Wt × number of motion ×10
Example:
4 months old infant, wt is 4kg, presented with vomiting 4 times per day and diarrhea 6 time daily.
Ongoing loss=4×10× 10=400 ml.

#Pediatrics

Interval of feed.

#Pediatrics

Remember:

1 gm of Hb yields about 34 mg of bilirubin.

#Pediatrics