clinical notes of pediatrics

Child abuse اطفال الشوراع Battered child syndrome

Indication of addmission in pneumonia

هودا 👑: Adverse Reactions: Seizures, peripheral neuropathy, GI upset, anorexia, constipation, headache, metallic taste, ECT changes, dysuria.

هودا 👑: Indications for FLAGYL: Susceptible anaerobic infections, including intraabdominal, skin and skin structures, gynecologic, bacterial septicemia, bone and joint, CNS, lower respiratory tract, endocarditis. C. Difficele colitis

هودا 👑: Bcg in the deltoid not in the tip of shoulder due to cervical lympoh node enlagement While deltoid result in axillary lymph node enlagement that means for cosmetic cause .

TB skin test   • Mantoux TST is the intradermal injection of 0.1 mL • purified protein derivative that induce induration through local vasodilation, edema, fibrin deposition. The amount of induration in response to the test should be measured 48-72 hr after administration. Tuberculin sensitivity develops 3 wk to 3 mo (most often in 4-8 wk) after inhalation of organisms. 😕😕 False-negative responses may occur: 1- early in the illness 2- with use of inactivated antigen (as a result of poor storage practice or inadequate administration) 3- as a result of immunosuppression (secondary to underlying illness, AIDS, malnutrition, or overwhelming tuberculosis). 😕😕 False positive response may occur: 1.BCG vaccination 2.Immune reactivity to non tuberculosis mycobacteria 3.Infection secondary to other mycobacterial species 4.A ruptured small venule at the time of injection 5.Measurement of erthema rather than of induration

  phototherapy causes diarrhea due to an induced lactase deficiency caused by bilirubin breakdown products .

Shigellosis High fever Bl. Diarrhea Neurological manifestation

Most common cause of chronic diarrhea in infant is post gastrointritis malabsorbtion syndrom In children is chronic non specific diarrhea

Liver span 4.5_5 cm at 1 wk At 12 yr 7_8 boys 6_6.5 girls

HUS microangiopathic hemolytic anemia TCP renal ibsufficiency Due to E. Coli toxin يجي اما ديهادريشن او فلود اوفر لود حسب منو الاكثر تاثير Diarrhea or renal Dx. Hb 5_9 g/dl Bl. Film (Helmit ,burr, fragmented RBC ) Retic .⬆ Plasma haptoglobin⬇ WBC ⬆ Plateleu⬇ Coombs _ve Renal biobsy If renal failure >2wks Normal platelets Ddx : Renal vein thrombosis Sle Malig. HT Complication Renal f. ,heart f. Seizure Inestinal comp. (Collitis ) TTT نسيطر عله كمية الفلود وdialysis وننقله RBC ما ننقل platelets

Before spleenactomy ?! Patient in need for triple vaccination ie: H influenzi..meningiococcal and pneumococcal Influenza vacc. Anuualy Long term pencillin v.( < 5 yr 125 twice daily . >5yr 500 mg 12 hrly if sensitive use vancomycin) After remission from Nephrotic s. Pat. Should be vaccinated by : 1. Ploy valent pneumococcal 2. Influenza 3. Varicella

Prolong fever in meningitis >10 days Causes Intercurrent viral. Inf. Nosocomial inf. 2ry bacterial inf. Thrombophlebitis Drug reaction 2ry fever ترجع ورا فترة يكون بيهه المريض afebrile عادة بسبب nosocomial inf.

Length at birth 50 cm Double 4 yr Triple 13 yr W8 At birth 3_3.5 kg Double 4_5 mo. Triple 1 yr Quad. 2 yr 7yr يتضاعف 7 time OFC At birth 34 cm اول 3 اشهر يزداد 2 سم بالشهر ثاني 3 اشهر 1 سم بالشهر 6 اشهر الوراهن 0.5 سم بالشهر صار سنه يوصل الى 43_46 سم Adult size 54 cm

خاف ننسى ✍ المكيال 4 غم الonz = 30 ml One onz / scoop Every onz= 20 kcal. Daily requirment 110_130 kcal.

Absence primitive reflex means cns disfunction Asymmetrical moro Due to Fracture clavicle Brachial plexus injury Hemiparesis