P year‎ > ‎Paediatrics‎ > ‎

12.09.27 Baby check + teaching notes

HSV
  • 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

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
    • cf Lactose

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
      • 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
Comments