PAEDIATRIC 👼🏻

👶🏻 An 8-month-old child has ❗️vomiting and screaming episodes for 12 hours. Physical examination reveals a ❗️sausage-shaped mass in the right upper quadrant. Dx , best next step ➡️ intussusception , barium enema study. 👶🏻 A 5-year-old girl diagnosed with pauciarticular juvenile idiopathic arthritis has a ❗️positive antinuclear antibody test , mostly associated with ➡️ uveitis 👶🏻 A 2-week-old infant presents with apnea. The infant was born at term after an uncomplicated pregnancy. The ❗️mother of this baby had rhinorrhea and cough that started 3 weeks ago and now she has a ❗️severe persistent cough with post-tussive emesis. Dx , Mx ➡️pertussis , azithromycin 👶🏻 A 14-month-old boy has a 4-month history of intermittent diarrhea. He frequently has explosive bowel movements containing food particles. He is ❗️growing well, is ❗️otherwise healthy, and has a ❗️normal physical examination. Next step ➡️ reassurance 👶🏻 A normal 6-month-old infant has a continuous cardiac murmur and bounding peripheral pulses. next step ➡️ surgical or catheter correction 👶🏻 A newborn has ❗️delayed passage of meconium stools and barium enema radiograph shows ❗️dilated proximal colon and small obstructed distal colon. DX & diagnostic test ➡️ Hirschsprung disease , rectal suction biopsies 👶🏻 infant is born to a mother who is HBsAg positive should Give infant hepatitis B immune globulin and hepatitis B vaccine 👶🏻 A 38-week infant is born to a mother with ges tational diabetes. Birth weight is 4255 g. What would you expect to see most commonly in this infant ➡️ cardiomegaly 👶🏻 A 2-year-old girl is listless and pale. You obtain a complete blood count and find that the patient has severe megaloblastic anemia. What additional history explains this ➡️ drinks exclusively goat milk. 👶🏻 A 12-month-old child has had ❗️poor weight gain. The child started to have ❗️loose stools at the age of 8 months and has a ❗️very poor appetite. On examination, you see a c🌚lingy, irritable child with very ❗️little subcutaneous fat and a protuberant abdomen. What is the next best test ➡️ IgA endomysial antibody 👶🏻 detection of Cryptosporidium in the stool of a patient with chronic diarrhea and malnu trition in the setting of human immunodefi ciency virus (HIV) infection 👶🏻 A 7-year-old boy has ❗️abdominal pain and a ❗️rash that started several days ago. On examination, you notice a ❗️palpable purpuric rash over his calves and buttocks with swelling of both ankles. Abdominal examination is unremark able. Dx , lab finding ➡️ HSP , normal clotting parameters 👶🏻 A 14-year-old girl with ❗️primary amenorrhea, and ❗️short stature, who has a his tory of repaired ❗️coarctation of the aorta in infancy , Dx , next step ➡️ turner syndrome , karyotype. 👶🏻 bacterial peritonitis is the major cause for mortality minimal changes nephropathy. 👶🏻 n 8-year-old boy are concerned about their son’s short stature , next step ➡️ determination of height velocity 👶🏻 Essential hypertension is the most com mon cause of hypertension among adolescents 👶🏻 A 4-year-old girl had bloody diarrhea for sev eral days. One week later she develops periorbital edema and fatique, Dx , lab finding ➡️ HUS , anemia and thrombocytopenia. #goldens

مهمات كلش ☝🏻

🫀most common CHD ➡️ VSD. 🫀most common Acyanotic CHD ➡️ VSD. 🫀 most common Cyanotic HD in children and adult ➡️ TETRALOGY OF FALLOT 🫀 most common Cyanotic HD in newborn ➡️ Transposition of great vessels 🫀 most common for VSD ➡️ Peri-membranous 🫀 most common cardiac lesion in infant to mother with congenital rubella syndrome ➡️ PDA. 🫀 most common cardiac lesion in infant male with turner ➡️ COARCTATION OF THE AORTA 🫀 most common cardiac lesion in infant of DM mother➡️ Transposition of great vessels 🫀 most common cardiomyopathy ➡️ dilated cardiomyopathy 🫀 most common symptomatic dysrhythmia in pediatric ➡️ SVT 🫀most common cardiac tumor ➡️ rhabdomyoma 🫀most common site for rhabdomyoma ➡️ ventricles 🫀most common site for fibroma ➡️ interventricular septum or free wall on any cardiac chamber 🫀most common site for myxoma ➡️ left atrium 🫀 SVT : Rate usually >220 beats/min (range, 180−320 beats/min); abnormal atrial rate for age; P waves may be present and are related to QRS complex; normal, narrow QRS complexes unless aberrant conduction is present. Rx : Increase vagal tone (bag of ice water to face, Valsalva maneuver), adenosine, digoxin, sotalol, electrical cardioversion if acutely ill, catheter ablation. 🫀 digoxin toxicity : Gastrointestinal upset is the most common symptom of digoxin toxicity. Patients also may report visual symptoms, which classically present as a yellow-green discoloration, and cardiovascular symptoms, such as palpitations, dyspnea, and syncope. Elderly patients frequently will present with vague symptoms, such as dizziness and fatigue. The most important historical detail in evaluating a random digoxin level is the time of the last dose. 🫀 CXR findings : ❗️TRANSPOSITION OF GREAT ARTERIES ➡️ egg on-side” appearence of heart with a narrow base and increase in pulmonary vascularity. ❗️TETRALOGY OF FALLOT ➡️ Coeur-en-sabot (boot shape) ❗️COARCTATION OF THE AORTA ➡️ irregular notching of the inferior margins of the posterior ribs resulting from collateral flow through dilated and pulsatile intercostal arteries ❗️PATENT DUCTUS ARTERIOSUS ➡️ Cardiomegaly, plethoric lung, and prominent pulmonary conus. 🫀 types of murmurs : ❗️VSD ➡️ Small : loud harsh, grade 4-6 pansystolic murmur at the lower left sternal border. large : soft with loud P2. ❗️ASD ➡️ Wide, fixed splitting of 2nd heart sound, soft ejection systolic murmur at the 2nd left intercostal space, no thrill (grade 3) & parasternal RV heave. ❗️PDA ➡️ continuous machinery murmur (systolic & diastolic) at the pulmonary area with a thrill #goldens

مجموعة ملاحظات وكيسات من اكثر من كتاب مهمات تفيدكم ان شاء الله ☝🏻😇

👶🏻 the most common chromosomal abnormality in Down syndrome ➡️ Nondisjunction 👶🏻 Mr and Mrs David are seen by the geneticists as their baby, Sarah, has Down syndrome. Her chromosomes are examined. Three copies of chromosome 21 are seen, one of which is attached to chromosome 14. How would you describe this abnormality. ➡️ Unbalanced Robertsonian translocation 👶🏻 Fiona is a well 4-year-old girl with ❗️Down syndrome. She attends her yearly follow-up appointment with her mother. There are no real problems other than ❗️constipation, for which her general practitioner has started treatment. When you plot Fiona on the Down syndrome growth chart, you notice that her ❗️height has gone from the 75th centile to the 25th centile. ❗️Her weight, however, has gone from the 50th centile to the 75th centile. Ix ➡️ Thyroid function tests 👶🏻 in a normal Down patient ,there is increased risk of future ➡️ leukemia 👶🏻 A 15-month-old boy, had been unwell with a ❗️runny nose and cough for a day when his father brings him to the Emergency Department. At lunch he ❗️suddenly became stiff, his eyes rolled upwards and both his arms and legs started jerking for 2 minutes. ❗️He felt very hot at the time. When examined 2 hours later, he has recovered fully. This is the ❗️first time this has happened. He has a ❗️normal neurological examination and is acquiring his developmental milestones normally. He has no other medical problems. The triage nurse performed a blood glucose test, which indicated a ❗️glucose level of 4.2 mmol/L (within normal range). Ix ➡️ no need 😇 👶🏻 2-year-old girl of Indian ethnicity who lives in the UK. She presents to her general practitioner as she has been ❗️unsteady on her feet for a day, ❗️having had diarrhoea during the previous week. On examination she is afebrile, has ❗️reduced muscle power and tone and ❗️no tendon reflexes can be elicited in her lower limbs. She is referred urgently to the paediatric hospital and 6 hours later she is unable to stand and the tendon reflexes in her upper limbs are now absent. She has no other medical problems and has been fully immunized. Dx ➡️ GBS 👶🏻 Folic acid prior to conception and early in pregnancy significantly reduces the chance of spina bifida 👶🏻 5-year-old girl, is seen by her general practitioner. Her ❗️mother and school teacher have noticed she has episodes where she stops her activity for a few seconds, ❗️stares blankly ahead and then ❗️resumes the activity as if she had never stopped. These episodes happen ❗️many times a day. She has no other medical problems and there is no family history of note. Dx ➡️ absence epilepsy 👶🏻 5-month-old infant who has been seen repeatedly by his general practitioner because of ❗️colic. His mother brings him to the Accident and Emergency department as he is having episodes of ❗️suddenly throwing his head and arms forward. These episodes ❗️occur in repetitive bursts. His mother thinks they may be something more than just colic, as he is now not smiling or supporting his head as well as he did previously. He was born at term by normal vaginal delivery and has no other medical problems. DX ➡️ Infantile spasms (West syndrome) #goldens

👶🏻 An 8-year-old child is hospitalized because of ❗️paroxysms of severe colicky abdominal pain which does not radiate to the back or the groin. Physical examination is unremarkable except for generalized abdominal tenderness. An exploratory ❗️laparotomy reveals an edematous intestine without specific lesions. The ❗️appendix appears normal but is removed. Postoperatively the abdominal pain persists, and ❗️hematuria develops. Values for BUN and creatinine are normal. On the second postoperative day, ❗️tender swelling of both ankles and knees is noted. Dx ➡️ HSP 👶🏻 Haloperidol is the drug of choice for Tourette syndrome :disorder characterized by blinking,twitching, grimacing, and jerking movements that often have a repetitive and semi purposeful character 👶🏻 A 3-month-old infant is hospitalized because of ❗️recurrent right focal seizures that are now generalized in nature. Birth and perinatal history are unremarkable. You note that the child has a ❗️flat, purplish-red skin lesion on the left side of the face ❗️extending onto the forehead. The remainder of the examination including a com plete neurologic examination is within normal limits. The results of a lumbar puncture are normal. Dx , CT findings ➡️ Sturge-Weber disease, gyriform calcifications 👶🏻 On routine examination of the children of a migrant farm worker, you notice that a 12-year-old child who has received little previous medical care is short and ❗️mentally retarded. Physical exam ination reveals that the ❗️liver is enlarged to 5 cm below the right rib cage, and the ❗️spleen is enlarged 6 cm below the left rib cage. ❗️Lumbodorsal kyphosis is prominent. The child has a ❗️peculiar facies with thick lips and a ❗️large tongue. Attempts to visualize the ❗️retina are unsuccessful because of clouding of the corneas. Dx , Urinary findings ➡️ Hurler syndrome , dermatan and heparan sulfate 👶🏻7-year-old boy now in your office was last seen 2 weeks ago with a ❗️mild viral upper respiratory tract infection. Today, however, he presents with ❗️fever, ataxia, weakness, headache, and emesis. In the office he has a 3 minute ❗️left-sided tonic-clonic seizure. You send him to the hospital and order a (MRI) of the brain, the results of which show ❗️disseminated multifocal white matter lesions that enhance with contrast, Dx ➡️ ADEM 👶🏻14-year-old girl with a history of seizures is admitted to the hospital with the diagnosis of status epilepticus. Her valproic acid level is in the therapeutic range. You arrange a24-hour video (EEG).During the EEG, she has several episodes of tonic and clonic movements with moaning and crying, with ❗️no loss of bowel or bladder control. The neurologist tells you that during the events the EEG had excessive ❗️muscle artifact but ❗️no epileptiform discharges. your next step ➡️ Request a psychiatric evaluation 👶🏻 Examination of (CSF) of an 8-year-old, ❗️mildly febrile child with nuchal rigidity and intermittent stupor shows the following: ❗️WBCs 85/μL (all lymphocytes), negative Gram stain, ❗️protein 150 mg/dL, and ❗️glucose 15 mg/dL. A computed tomographic (CT) scan with contrast shows enhancement of the basal cisterns by the contrast material. Dx ➡️ Tuberculous meningitis #goldens

👶🏻 genetic transmission of cystic fibrosis is ➡️ autosomal recessive. 👶🏻 the most common cause of nephrotic syndrome in childhood ➡️ Minimal-change disease 👶🏻 side effect of phenytoin ➡️ gingival hyperplasia. 👶🏻 A term infant is born to a mother who has been using crack cocaine. This infant is at increased risk for➡️ IUGR. 👶🏻 You examine an 18-year-old male college student with a 5-day history of ❗️fever, ❗️sore throat,and fatigue. Physical examination reveals an exudative tonsillitis and ❗️bilateral enlarged and slightly tender posterior cervical lymph nodes.The ❗️spleen is palpable 3 cm below the rib cage. DX ➡️ infectious mononucleosis (Epstein-Barr virus) 👶🏻 Fetal distress is the major risk factor for meconium aspiration 👶🏻 The most common cardiac lesions in children with Down syndrome : ❗️atrioventricular septal defects, ventricular septal defects and atrial septal defect, or patent ductus arteriosus. 👶🏻 Acellular pertussis vaccine is prefered on whole one due to associated with fewer side effects. 👶🏻 It is recommended that young infants should sleep in the supine rather than in the prone position because due to risk of ➡️ sudden infant death. 👶🏻 feeding of honey to infants less than 6 months of age has been associated with ➡️ botulism 👶🏻 A3-month-old infant presents with poor growth and inadequate weight gain. There is ❗️no history of vomiting or diarrhea. Except for the ❗️appearance of malnutrition and lack of subcutaneous fat,the physical examination is normal , most common cause ➡️ nonorganic cause 👶🏻 A 2-year-old child is being evaluated because the mother notes that her right eye has been turning in. Physical examination documents ❗️strabismus with a right esotropia. Attempts to visualize the fundi are unsuccessful, but it is noted that the ❗️red reflex is replaced by a yellow white pupillary reflex in the right eye. Dx ➡️ retinoblastoma 👶🏻 A 2-year-old child is admitted because of ❗️weakness proceeding to coma. According to the parents, he had been ❗️well until several hours prior to admission, when they noted ❗️diarrhea, cough, wheezing, and sweating. Physical examination reveals a ❗️comatose child with ❗️diffuse weakness and ❗️areflexia. ❗️Pupils are pinpoint and unrespon sive. Examination of the chest reveals generalized wheezing. Oral secretions are copious. DX , RX ➡️ organophosphate poisoning . atropine 👶🏻 A3-week-old infant is admitted with vomiting of 5 days’ duration. Physical examination reveals a rapid heart rate, evidence of dehydration, and ❗️ambiguous genitalia. Serum electrolytes are ❗️Na+ 120 meq/L, ❗️K+ 7.5 meq/L, ❗️HCO3− 12 meq/L,BUN 20 mg/dL. Dx , Mx ➡️ (CAH), IV fluid & hydrocortisone. 👶🏻 Erythema nodosum is a reactive phenomenon characterized by tender,erythematous nodules 1–2 cm in diameter. 👶🏻 An 18-year-old boy presents with ❗️cough, chest pain, and low-grade nightly fevers of several weeks duration. He has a ❗️4-year history of smoking two packs of cigarettes per day. Chest x-ray reveals a ❗️large mass in the mediastinum with extension into the right upper chest. DX ➡️ lymphoma 👶🏻 A 12-year-old child is seen because of a ❗️rash and ❗️severe headache which began 2 weeks after ❗️returning from vacation in Massachusetts. The skin lesion began as a red macule on the thigh, which gradually expanded over 1 week to reach approximately 15 cm in diameter with ❗️red borders and central clearing. The lesion is slightly painful. A few days after the onset of the skin manifesta tion, the child developed severe headache, myal gias, arthralgias, and malaise. Low-grade fever was present. The mother recalls that the child was bitten by a tick about 1 week prior to the onset of symptoms. cause , Rx ➡️ spirochete B burgdorferi , doxycycline #goldens

وإن كان اللقاء بكَ يا حلمي مستحيلاً ، فأني للمستحيلِ فاعلٌ 🌨!

طلابنه هذي محاضرات النفرو والنيورو الي بالوزاري وما عدنه ملونة ومرتبة يا رب تفيدكم ☝🏻😇

قناة جدا مفيدة

الله يجزيهم الخير حالين مصدر Nelson يا رب يفيدكم يا ابطال ☝🏻😇

مصادر الاسئلة واللي اشوفه بعد مهم هم انزله ان شاء الله