-The average diameter of the anterior fontanel in an infant is 2.1 x 2.1 cm.

-The size may vary from 0.6 to 3.6 cm.

-It may be up to 4 or 5 cm in some normal infants and may even enlarge in the first few months of life

-The usual time of closure of the anterior fontanel is 7-19 months of age.

#Pediatrics

Meningitis irritation signs do not appear before 18 months of age, why?

-Because Anterior fontanel is still open, so symptoms and signs of meningitis are not specific in that age. So do LP.

#Pediatrics

Craniotabes:

-It may be physiologically present up to 3 months of age.
-Rickets
-Hydrocephalus
-Hypervitaminosis A
-Osteogenesis imperfecta
-Premature
-Congenital syphilis.

#Pediatrics

When is meconium normally passed?

-95–97% of healthy term newborns pass meconium in the first 24 hours.

-Sick term infants and healthy preterm infants may not pass meconium for 3–5 day.

#Pediatrics

Remember:
Interferon-γ release assay (IGRA):

-Preferred test in individuals with prior BCG vaccination.

-Results are available within 24 hours.

#Infections

Remember:

Fever+ pharyngitis+lymphadenopathy 👉🏼glandular fever
(infectious mononuclosis).

#Infections

Remember:

-Monospot test has a specificity of85% & a sensitivity of 100% for diagnosis of infectious mononucleosis.

#Infections

-The triad of portal vein thrombosis, hemolysis, and pancytopenia suggests Paroxysmal nocturnal hemoglobinuria (PNH).

#Blood

Causes of death in Kala-azar:

-If no treatment is given, patient may die within 1 to 2 year due to:
1- Secondary infection
2- Bleeding.

#Infections

In Kala-azar:

CBC—leukopenia, high lymphocyte and monocyte, neutropenia, absence of eosinophil, thrombocytopenia and high ESR. If CBC is repeated after some days, there is progressive leukopenia.

#Infections

•What are the pathological stages of Pneumonia?

1-Stage of congestion—persists for 1 to 2 days
2-Stage of red hepatization(red and solid like liver)—persists for 2 to 4 days
3-Stage of grey hepatization—persists for 4 to 8 days
4-Stage of resolution—8 to 9 days or more.

#Respiratory

How is the appetite in Kala-azar?

-Usually good.

Remember:
-Usually no anorexia, no malaise, no coated tongue.

#Infections

•Leishmania has two forms:
amastigote and promastigote.

-Amastigote form "oval" is found in human, LD body is found in monocyte macrophage system. It's the diagnostic stage.

-Promastigote form (flagellate) is found in sandfly, and in culture media.It's the infective stage.

#Infections

•What are the complications of kala-azar?

1-Secondary infection (pneumonia, tuberculosis)
2-Anemia
3-Bleeding
4-Gastroenteritis, bacillary dysentery
5-Liver disease (cirrhosis of liver)
6-PKDL
7-Rarely, cancrum oris.

#Infections

•Sepsis:
-It is a severe, life-threatening condition that results from a dysregulation of the patient's response to an infection, causing tissue and organ damage and subsequent organ dysfunction.

•Septic shock:
-It is a sepsis syndrome accompanied by circulatory and metabolic abnormalities that can significantly increase mortality .

Diagnostic criteria:

-Persistent hypotension: Vasopressors are required to maintain mean arterial pressure(MAP) ≥ 65 mm Hg.

-Persistent lactic acidosis: lactate > 2 mmol/L(18 mg/dL) despite adequate fluid resuscitation.

#Surgery
#Medicine

Marasmus vs Severe dehydration.

#Pediatrics

Remember:

-Not all patients with Cerebral palsy have learning disabilities "MR", it's present in about 60٪.

#Pediatrics

-The term 'kwashiorkor' means the influence on the older child when the next baby is born.

It is characterised by three essential clinical features:
• Retarded growth
• Psychomotor changes
• Oedem.

#Pediatrics