-Neonates, infants and children with suspected Inborn Errors of metabolism.
-Classification of IEM.

#Pediatrics

Somogyi and Dawn phenomena:


Somogyi effect:
-Occurs in a patient with type 1 DM who may develop nocturnal hypoglycemia (due to high dose of night NPH insulin) which may inturn stimulate a surge of counter-regulatory hormones to produce high blood glucose levels by 7 AM.

-Checking blood sugar at 3 AM "low" and 7 AM "high".

Dawn phenomenon:
-Occurs in about 75٪ of type 1 DM patients, also occurs in type 2 and normal persons. It is characterized by reduced tissue sensitivity to insulin developing between 5-8 AM causing fasting hyperglycemia.

-It may be due to spikes of growth hormone released at the onset of sleep.

-Blood sugar at 3-4 AM" not low" and at 7 AM "high".

#Pediatrics

Tetanus vaccine of mother.

#Pediatrics

Remember:

-Primary Microcephaly It is also called true microcephaly or microcephaly vera.

#Pediatrics

In DIC:

•Coagulation panel:

↑ aPTT, ↑ PT
↓ Fibrinogen
↑ D-dimer
↑ Bleeding time
Coagulation factors:
 ↓ factor V and ↓ factor VIII

•CBC and blood smear
↓ Platelet count
↓ Hct
Schistocytes.

#Pediatrics

Remember:

-Spastic Cerebral Palsy is the most common type of cerebral palsy and occurs in 70%-80% of all cerebral palsy cases.

-More than 50% of these patients are of low birth weight.
- Intelligence is normal or borderline.
-Apraxia is common.
-Causes include perinatal hypoxia and kernicterus.
-Only 8%-10% of cases with cerebral palsy have a history of birth asphyxia.

#Pediatrics

Temporary:

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