HSV- Subtypes
- HSV-1 => most cold sores
- HSV-2 => most genital herpes
- Prevalence in adults
- Incidence of genital HSV2 in children: 1 in a million per year
Hepatitis C
- Often asymptomatic
- Chronic infection can lead to scarring of the liver and ultimately to cirrhosis
- Spread primarily by blood-to-blood contact associated with intravenous drug use, poorly sterilized medical equipment and transfusions
- The virus persists in the liver in about 85% of those infected
- Persistent infection can be treated:
- Combination of peginterferon and ribavirin
- Overall, 50–80% of people treated are cured
Abdominal exam- Causes of enlarged spleen
- Tumour
- Malaria
- Hereditary spherocytosis
- EARLY sickle cell
- Eventually => autosplenectomy
- Rare stuff
- Causes of abdo troubles
- 1-2 weeks: Pyloric stenosis
- 6-9 months: Celiac
- 6-9 months: Intussusception
- Variable: Cystic fibrosis
- Poo starts like tar
- Then => whole-grain mustard if breast fed
- Then => English mustard if formula fed
- Distinguishing spleen from kidney
- Can't get above it
- Moves with breathing
- Notch (hard to feel in kids)
- Notes
- Huge spleen, otherwise well => Hereditary spherocytosis
Celiac disease- Presents around 6-9 months, after weening
- Check antibodies PLUS total IgA
- Then biopsy for a definitive diagnosis
- Then gluten-free diet
- All tests should become negative
- => Can re-test to check compliance
Mitochondrial neurogastrointestinal encephalopathy (MNGIE)
- Rare, autosomal recessive
- Usually appears between the second and fifth decades of life
- Those with MNGIE are often thin, experiencing continuous weight loss
- Gastrointestinal:
- Dysmotility
possibly resulting in pseudo-obstruction
- Borborygmi, early satiety, diarrhea, constipation, gastroparesis, nausea, vomiting, weight loss, diverticulitis
- Neurological:
- Diffuse leukoencephalopathy, peripheral neuropathy, myopathy
- Ocular:
- Retinal degeneration, ophthalmoplegia, ptosis
Galactosaemia- Autosomal recessive
- Incidence is 1 per 60,000 births for Caucasians
- Can't metabolise galactose
Notes- Hamartoma
- Benign, focal malformation
- Resembles a neoplasm but not malignant
- Grows at the same rate as the surrounding tissues
- Malignant tumors
- Mesenchymal => Sarcoma
- Epithelial => Carcinoma
- Blood in the wrong place
- Haematoma: Within tissue
- Ecchymosis: Thin layer spread under skin
- Tongue tie doesn't generally have any consequences for feeding or language development
- Can impair feeding if very far forward
- Creon
- Amylase, lipase, protease
- Used as pancreatic enzyme replacement in CF
- Hypovolaemic shock
- => Sluggish venous flow
- => Thrombosis in big veins
- Endothelium is ALWAYS leaky
- Epithelium is sometimes leaky too, but can have tight junctions
- Laryngomalacia
- First presents around 3-4 weeks
- Usually resolves in 6 months
- Caused by hypocalcaemia?
- Primary ciliary dyskinesia
- 50% have dextrocardia
- Cilia normally move the heart across
- Without them, it's 50:50
- Sinusitis is common
- Chromosome nomenclature
- Long arm = q
- Short arm = p
- DiGeorge syndrome
- Many possible deletions around 22q11.2
- CATCH-22
- Cardiac Abnormality (especially tetralogy of Fallot)
- Abnormal facies
- Thymic aplasia
- Cleft palate
- Hypocalcemia/Hypoparathyroidism
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