• Subtypes
• HSV-1 => most cold sores
• HSV-2 => most genital herpes
• But 10% is from HSV1
  
• Prevalence in adults
• 5-10% HSV2
• 70-80% HSV1
• 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
  

• 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

• 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
  

• 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

• Autosomal recessive
• Incidence is 1 per 60,000 births for Caucasians
• Can't metabolise galactose
• cf Lactose
  

• 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
• Sagittal sinus
• Renal vein
• Endothelium is ALWAYS leaky
• Epithelium is sometimes leaky too, but can have tight junctions
• Laryngomalacia
• First presents around 3-4 weeks
• Noisy breathing
• 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
• Can look a bit like CF
• 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