Act as Pediatrician 👶

Grade 1: Obliteration of the Lovibond Angle accompanied by softening and increased fluctuancy of the nail bed base (Schamroth's sign can be lost or altered). Grade 2: Increase in Longitudinal and Transverse Curvature. The nail develops a parrot-beak appearance, showing heightened convexity across both axes. Grade 3: Drumstick Appearance. Pronounced soft tissue hypertrophy accumulates around the nail matrix, causing the distal phalanx to visibly resemble a drumstick. Grade 4: Hypertrophic Osteoarthropathy (HPO). Advanced presentation involving periosteal new bone formation (visible on X-rays as subperiostwal linear proliferation) affecting the tubular bones of the forearms, legs, and adjacent large joints (ankles, knees, wrists), frequently accompanied by painful arthralgia. #pediatrics

• Rosenbach: systolic liver pulsation. • Gerhardt: systolic spleen pulsation. #pediatrics

• Traube: “pistol-shot” sounds over femoral artery. • Duroziez: systolic + diastolic to-and-fro murmur over femoral artery with compression. #pediatrics

• De Musset: head nodding with each heartbeat. • Quincke: visible capillary pulsation in nail bed. • Müller: systolic pulsation of the uvula. • Becker: visible retinal arterial pulsation. • Landolfi: alternating pupillary constriction and dilatation.

Peripheral signs of Aortic Regurgitation (AR) : Pulses & BP • Corrigan / Water-hammer pulse: bounding pulse with rapid rise and sudden collapse. • Wide pulse pressure: ↑ SBP + ↓ DBP. • Hill sign: popliteal SBP > brachial SBP by >20–60 mmHg. • Mayne sign: DBP falls >15 mmHg when the arm is elevated. #pediatrics

#Signs_and_symptoms_of_rickets. 1/ bone tenderness 2/susceptibility for bone fractures particularly greenstick fractures. 3/craniotabes 1st sing. 4/ skull bossing 5/ delayed closure of the fontanelles 6/bowed legs 7/ thickened ankles and wrists. 8/knock knees 9/kyphoscoliosis 10/ lumbar lordosis . 11/ rachitic rosary . 12/ Harrison's groove. 14/Hypocalcemia. 15/ tetany. 16/ Dental problems. 17/ caput quadratum. 18/wide sutures