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🔴Stridor
▪︎Harsh Continues Inspiratory Sound Produced By Partial Obstruction Of Upper Airways (Trachea/Larynx)
🔹Grades Of Stridor📍1. Exertional ➡️ At Crying Or Exercise 📍2. Continuous ➡️ Present At Rest ➡️ Hospital Only If Age <1 Year 📍3. Retraction ➡️ Continuous + Muscle Retraction ➡️ Need Hospital 📍4. Cyanosis ➡️ Continuous + Muscle Retraction + Cyanosis (Impending Respiratory Failure) ➡️ Need Immediate Hospital & ET Intubation
🔹Causes Of Stridor📍1. Acute Infections : ▪︎Viral ➡️ CROUP (LaryngoTracheoBronchitis)/Acute Laryngitis/Spasmodic Laryngitis ▪︎Bacterial ➡️ Acute Epiglottitis/Acute Tracheitis/Diphtheritic Laryngitis 📍2. Non Infectious : ▪︎Acute ➡️ Foreign Body/Tetanic LaryngoSpasm/Allergic Laryngeal Edema/Acute Laryngeal Compression ▪︎Chronic Acquired ➡️ Laryngeal & Tracheal Stenosis/Laryngeal Muscle Paralysis/Laryngeal Tumors ▪︎Chronic Congenital ➡️ LaryngoMalacia/TracheoMalacia/Laryngeal Webs & Cysts/Vascular Rings
🔶A. CROUP (LaryngoTracheoBronchitis)▪︎Most Common Viral Infection Of Upper & Middle Airways (Trachea/Larynx/Bronchi) ▪︎Mostly Affect Children At 6 Months-3 Years Of Age At Fall & Winter ▪︎Mostly Due To ParaInfluenza (Type 1-3)/RSV/Influenza/AdenoVirus
🔹Clinical Features & Dx📍1. Start As Low Grade Fever With Rhinitis & Severe Barking Harsh Cough & Hoarseness (Develop Over Days) 📍2. Then Inspiratory Stridor 📍3. Then Signs Of Upper Airway Obstruction ➡️ Difficult Labored Breathing/Cyanosis/Muscle Retraction 📍4. Symptoms Worse At Night & Increase By Crying & Agitation 📍5. AP Xray Of Neck ➡️ Steeple Sign (SubGlottic Narrowing Of Trachea)
🔹Mx📍1. Oxygen 📍2. Systemic Steroids : ▪︎Dexamethasone (0.6 mg/Kg) ▪︎Inhaled Budesonide (2-4mg) ▪︎Prednisolone (2 mg/Kg/Day) 📍3. Nebulized Epinephrine (Racemic Adrenaline 0.25-0.5 ml in 3ml Saline Repeated Every 20 min)
🔹Complications1. Viral Pneumonia (Most Common) 2. Bacterial Tracheitis (SuperInfection)
🔶B. Acute Epiglottitis (SupraGlottitis)▪︎Acute Life Threatening Bacterial Infection Of Epiglottis لسان المزمار ▪︎Mostly Affect Children At 3-7 Years Of Age ▪︎Mostly Due To H.influenza/GA Streptococcus/Staph.Aureus
🔹Clinical Features & Dx📍1. Sudden Onset Of High Fever With Rapidly Progressive Stridor & Laboured Difficult Breathing (Develop Over Hours) 📍2. Then Severe Airway Obstruction With Cyanosis & Death Develop Within Hours 📍3. Child Prefer To Sitting & Lean Forward & Open The Mouth (Sniffing Position) & Saliva Drooling (inability To Swallow) 📍4. Lateral Neck Xray ➡️ Thumb Sign (Thickened & Bulging Epiglottis)
🔹Mx (Medical Emergency)📍1. EndoTracheal Intubation Or Tracheostomy (Kept For 2-3 Days) 📍2. Blood Culture 📍3. IV Antibiotics (IV Ceftriaxone/Cefotaxime/Meropenem) For 10 Days
🔶C. Bacterial Tracheitis▪︎Acute Bacterial Infection Of Trachea ▪︎Mostly Due To Staph.Aureus (After Viral CROUP) ▪︎Mostly Affect Children <3 Years Of Age
🔹Clinical Features & Dx📍1. Start As CROUP Then Develop High Grade Fever & Progressive Stridor & Patient Become Toxic 📍2. Airway Obstruction Becomes Severe Similar To Acute Epiglottitis ➡️ But With Normal Epiglottis By Laryngoscope 📍3. Leukocytosis
🔹Mx📍1. Airways Visualization & Debridement 📍2. EndoTracheal Intubation If Needed 📍3. Anti-Staph Antibiotics (Vancomycin/Naficillin/Oxacillin)
🔶D. Spasmodic Laryngitis ➡️ Acute Recurrent Attacks Of Croupy Cough & Stridor More At Night Due To Viral Or Allergic Conditions
🔶E. Acute Viral Laryngitis ➡️ Common Mild Viral Infection Of Children At 1-3 Years Start As Mild Fever & Rhinitis & Croupy Cough Then Subside in Few Days**** ▪︎Bronchiolitis (Lower Airways Infection) ➡️ RSV/Wheeze ▪︎CROUP ➡️ ParaInfluenza/Steeple Sign/Severe Barking Harsh Cough ▪︎Acute Epiglottitis ➡️ H.influenza/Sniffing Position/Saliva Drooling/Thumb Sign/EndoTracheal Intubation ▪︎Bacterial Tracheitis ➡️ Staph.Aureus After CROUP/Similar To Acute Epiglottitis But Normal Epiglottis
هذه ملفات approach أو diagnostic algorithm للأطفال
من الاعراض تسهلك الوصول للتشخيص مع الخطوة التالية والفحوصات
ملفات مفيدة جدا.
Repost from N/a
🕊️✨ اللهم صلِّ على الحبيب المصطفى محمدٍ القائد المجاهد، والبطل المقدام، الذي علّمنا أن العزة بالجهاد وأن النصر مع الصبر. صلاةً تثبت بها أقدام المجاهدين، وتقوي بها عزائم المرابطين، وتزلزل بها عروش الظالمين. وسلم عليه وعلى آله الطاهرين، عدد ما تعاقب الليل والنهار وعدد طلقات المجاهدين في سبيلك.🕊️🍃✨
🔴Bronchiolitis
▪︎Inflammatory Obstruction Of Small Lower Airways (Bronchioles) Leads To Bronchospasm & Increase in Mucus Production▪︎Mostly Affect Infants & Young Children in 1st 2 Years Of Life (Peak At 2-6m Age) ▪︎More At Winter & Early Spring & More in Boys Live in Crowded Conditions & Not Breast Fed ▪︎Contagious & Spread By Contact
🔹Causes1. Most Common ➡️ Respiratory Syncytial Virus (RSV) 2. Others ➡️ Influenza/Parainfluenza/Adeno & Rhino Viruses/Mycoplasma Pneumonia/Human Metapneumovirus/Corona Virus
🔹Clinical Features & Dx1. Start As Common Cold Symptoms (Cough & Rhinorrhea) 2. Then Audible Wheeze & Noisy Raspy Breathing (صوت تنفس خشن) & Low Grade Fever With Dyspnea & Irritability 3. In Young Infants & Premature Infants ➡️ Apnea Could Be The 1st Sign 4. On Chest Examination ➡️ Bilateral Expiratory Wheeze & Fine Crackles/HyperResonant/Chest Hyperinflation 5. On Xray ➡️ Lung Hyperinflation & Increase Lucency & Patchy Atelectasis/Flat Diaphragm
🔹DDX1. Asthma ➡️ Recurrent Episodes Of Wheeze/+Ve Family Hx/No Fever/Present in Older Children 2. Cardiac Asthma ➡️ Left Side Heart Failure & Pulmonary Edema 3. Cystic Fibrosis ➡️ +Ve Family Hx/Poor Growth/Chronic Diarrhoea 4. Pneumonia/Pertussis/GERD 5. Foreign Body Obstruction 6. Congenital Airway Obstruction (Tracheomalacia/BronchoMalacia/Vascular Ring)
🔹Mx (Supportive)
📍1. Head & Chest Elevation 30° With Neck Extension
📍2. Respiratory Support :▪︎Humidified Oxygen Through Nasal Cannula ▪︎CPAP Or Intubation & Mechanical Ventilation If Needed ▪︎Airway Suctioning & NG Tube Feeding To Prevent Aspiration
📍3. Supportive Drugs :▪︎Bronchodilators ➡️ Mild Short Term Improvement ▪︎Antibiotics ➡️ If Secondary Bacterial Infection Suspected ▪︎Aerosol Ribavirin (Anti-Viral) ➡️ For Infants With CHD Or Chronic Lung Disease ▪︎Steroids & Nebulized Epinephrine Or HyperTonic Saline
📍4. Indications For Hospitalization :▪︎Young Infant (Age <12w) & Preterms ▪︎Respiratory Distress (Apnea/Hypoxemia/High Tachypneia) ▪︎Child Can't Take Oral Feeding ▪︎Child With Other Conditions (Cardiac/Pulmonary/Immunological Diseases)
📍5. Prevention Of Bronchiolitis :▪︎Palivizumab (RSV Specific Monoclonal Antibody Given Before & During RSV Season For Risky Infants) ▪︎RSV IVIG ▪︎Influenza Vaccine
🔹Complications Of Bronchiolitis📍1. Respiratory Failure 📍2. Apnea in Very Young Infants 📍3. Asthma Or Wheeze Episodes in Future 📍4. Recurrence Of Bronchiolitis 📍5. Severe Dehydration 📍6. Lung Collapse Or Pneumothorax .... Wheeze/RSV ➡️ Bronchiolitis
📌 طب الأطفال
🔺مرجع نيلسون مترجم إلى العربية
▪️ عدد الصفحات 3525
واحد من أكثر المراجع شهرة والمفضلة بين أطباء الأطفال حول مواضيع أساسيات ومبادئ طب الولدان والخدج والأطفال - Essential Nelson
Pediatric development 2026
شير جديد بتنسيق وتنظيم وصور موضحة يسهل عليكم دراسة المادة العلمية لطب الاطفال
بالتوفيق للجميع
Repost from N/a
قد زين الأشعار اسم المصطفى وبــه علا بين الورى الإبـــداعُ..
يتسابقون بمدحهم لشفيعهم في شعرهم يشدو به الإجماعُ..
هيَّا معي حيّوا الفضيل تحيةً حتى تسرّ من اللقـــاء بقـــاعُ..
درب التوسط لا غلوٌ أو جفا إذ يقتدي في فعله الأتبــــاعُ..
فصلاتنا وسلامنا صوب الهدى في طيبة العظمى هناك مُذاعُ..ﷺ﴿اللَّهُمَّ صَلِّ وَسَلِّمْ وَبَارِكْ عَلَى سَيِّدُنَا مُحَمَّدٍ وعلى آله ﷺ ﴾.. *🌹💓صلوا على الحبيب💓🌹* ✍🏻💚🕊️🌴
🔴Gastroenteritis (GE) & Dehydration▪︎Clinical Syndrome Of Diarrhea & Vomiting Due To Infectious & Inflammatory Process Affect The GIT
🔹Types Of Diarrhea📍1. Acute ➡️ Acute Onset Of Excessive Loose Stool (>10ml/Kg/Day in Infants & >200g/24h in Older Children) For <14 Days 📍2. Chronic (Persistent) ➡️ Acute Episode Of Diarrhea Persist >14 Days 📍3. Secretary ➡️ Direct Stimulation Of Intestinal Mucosa To Secrets Fluids & Electrolytes Into The Bowel Lumen (Mostly Due To Cholera Toxins) ▪︎Stool Volume >200ml/Day ▪︎Na Content >70mEq/L ▪︎Ph >5 📍4. Osmotic ➡️ Malabsorption Of Ingested Substances Causing Water Pulling From intestinal Walls Into The Lumen (Mostly Due To Lactose Intolerance/Laxatives) ▪︎Stool Volume <200ml/Day ▪︎Na Content <70mEq/L ▪︎Ph <5 ▪︎Diarrhea Resolve By Stops Feeding ▪︎+Ve Reducing Substances 👇 هذي مواد لها القدرة على امتصاص الماء من جدران الخلايا (وجودها بالستول معناه ان الدياريا اوزموتك)
🔹Causes Of GE📍1. Viral ➡️ Mostly Occur in Winter/Mild & Self Limited in 3-7 Days/Watery/With Low Grade Fever ▪︎RotaVirus ➡️ Most Common Cause Of Diarrhea In Children ▪︎NoroVirus ➡️ Most Common Cause Of Gastroenteritis Outbreaks (Highly Contagious) & Occurs At Any Age 📍2. Bacterial ➡️ More in Summer/With Cramping Abdominal Pain & High Grade Fever/Severe in Nature ▪︎Bloody (Dysentery Due To Colon & Rectum Involvement) : •Salmonella/Shigella •Enterohaemorrhagic & Invasive E.coli •C.Difficile (After Antibiotics) •Yersinia ▪︎Watery (Secretary) : •Cholera •EnteroPathogenic & Toxigenic (Traveller's Diarrhea) E.coli •Food Poisoning (Staph/Bacillus/C.Perfringens) ▪︎Start Watery Then Becomes Bloody ➡️ Campylobacter Jejuni (Most Common Cause Of Bacterial Gastroenteritis) 📍3. Protozoal ▪︎Giardia ➡️ Offensive Watery Diarrhea/Abdominal Pain & Distension & Bloating/Malabsorption (Resemble Celiac)/Secondary Lactose Intolerance & Weight Loss ▪︎Entamoeba Histolytica (Amoebiasis) ➡️ Bloody Offensive Diarrhea With Mucous & Tenesmus & RLQ Abdominal Pain (Mimic Appendicitis) & Flask Shape Ulcers
🔹Complications1. Dehydration ➡️ Main Cause Of Death 2. Hypovolaemic & Septic Shock 3. Acute Renal Failure (Due To Renal Hypoperfusion) 4. Metabolic Acidosis (Due To Bicarbonate Loss in Stool Or Acute Renal Failure) 5. Electrolytes Disturbances ▪︎Low K ➡️ Paralytic Ileus/Hypotonia/Apathy/Arrhythmia ▪︎Low Ca ➡️ Tetany & Convulsions ▪︎Low Or High Na & Hypoglycemia ➡️ Convulsions 6. Bleeding (DIC & Sepsis)/Persistent Diarehea 7. Hemolytic Uremic Syndrome (By Enterohemorrhagic E.Coli)
🔹DDX1. Coeliac Disease/Cow's Milk Allergy 2. Acute Appendicitis/Pyloric Stenosis/Hirschsprung's/Intussusception/Necrotizing Enterocolitis 3. DKA/Hemolytic Uremic Syndrome 4. Hepatitis A/UTI/Respiratory Infection/Otitis Media/Meningitis/Septicaemia
🔹Mx ➡️ Supportive📍1. Correct Dehydration 📍2. AB If Indicated ➡️ Bloody Diarehea/Cholera/Protozoa/Severe Malnutrition/Toxic Febrile Child/Age <3m/Associated Pneumonia ▪︎Ciprofloxacin ➡️ Salmonella/Shigella/Yersinia ▪︎Vancomycin/Metronidazole/Fidaxomicin ➡️ C.Difficile ▪︎Tetracycline/Doxycycline/Ciprofloxacin ➡️ Cholera ▪︎Metronidazole ➡️ Protozoa 📍3. Continue Feeding 📍4. Zinc Supplements (10-20mg For 10-14 Days) ..... Most Common Viral GE ➡️ RotaVirus Most Common Bacterial GE ➡️ Campylobacter Jejuni Malabsorption ➡️ Giardia Flask Shape Ulcer/Resemble Appendicitis ➡️ Entamoebia Histolytica Topic of the day is #Gastroenteritis @Clinicalpediatricround
Nelson Pediatric Textbook of Rare Diseases, 1st Edition 2027
= This book is a member of the Nelson Textbook of Pediatrics family, with all the quality and meticulousness that would be expected of a Nelson publication, and offers greater, in-depth information about rare diseases including details about the phenotype, etiology, pathophysiology, differential diagnosis, accurate diagnostic testing, and, in a growing number of disorders, specifications therapy.
🔴Cerebral Palsy (CP)
▪︎It's A Group Of Permanent Neurological Dysfunctions Arise From Structural Abnormalities in The Developing Brain Of The Baby Before Or After Birth▪︎It's The Most Common Cause Of Motor Impairment in Children ▪︎Usually Dx At Age Of 18m After Delayed in The Motor Development ▪︎Characterized By :
📍1. Permanent Non-Progressive Dysfunction (But Changing)يعني يبقى على حاله لا يسوء اكثر ولا يتحسن بس شوية تصير اختلافات بمرور الوقت
📍2. Usually Affects Motor Functions (Movement & Posture Impairment Due To Dysfunction in Motor Centres Like Cerebral Cortex/Cerebellum/Basal Ganglia)
📍3. Associated With Mental Retardation/Behavioural & Emotional Disturbances/Vision & Hearing Impairment/Epilepsy
🔷Causes & Risk Factors Of CP 🔸A. During Pregnancy (Pre-Natal 80%) :📍1. Congenital Causes (Congenital Brain Malformations/Congenital Infections TORCH/Genetic Syndromes) 📍2. Maternal Risk Factors (Low Socioeconomic State/Seizures/Eclampsia/Diabetes & Hypertension/Drugs/Bleeding/Infection/Polyhydramnios/Abnormal Fetal Presentation/Multiple Births)
🔸B. During Birth (Natal Or Peri-Natal 10%) :📍1. Low Birth Weight & Prematurity 📍2. Hypoxia Ischemic Encephalopathy (HIE Most Important) 📍3. Birth Trauma
🔸C. After Birth (Post-Natal 10%) :📍1. Meningitis & Head Trauma (Most Common Cause Of Acquired CP) 📍2. Other Causes : ▪︎Encephalitis ▪︎Hypoglycemia ▪︎Hyperbilirubinemia (Kernicterus) ▪︎Hydrocephalus ▪︎Inborn Errors Of Metabolism (PKU) ▪︎IntraVentricular Haemorrhage in VLBW Infants
🔷Types Of CP 🔸A. According To Site Of Body Involvement📍1. HemiParesis (HemiPlegia) ➡️ Motor Impairment Of One Side Of The Body (Unilateral Impairment Of Arm & Leg On The Same Side) 📍2. DiPlegia ➡️ Motor Impairment Of The Lower Limbs (If Only Lower Limbs Affected It's Called ParaPlegia But If Lower Limbs + Some Limitations in Upper Limbs It's Called DiPlegia) 📍3. QuadriPlegia ➡️ Motor Impairment Of All Limbs (Whole Body) 📍4. MonoPlegia ➡️ Motor Impairment Of Only One Limb
🔸B. According To Type Of Motor Disorder📍1. Spastic CP : ▪︎Most Common Form Of CP (70-80%) ▪︎Results From Injury To Upper Motor Neurons Of The Pyramidal Tract ▪︎Usually Bilateral ▪︎Characterized By : I. Increase Muscle Tone (Spasticity) II. Pathological Reflexes (+Ve Babinski & HyperReflexia/Persistent Primitive Reflexes) III. Abnormal Movement IV. Pseuedo-Bulbar Palsy (Poor Sucking & Swallowing/Squint/Speech Abnormalities) V. Types : ▪︎Spastic DiPlegia (35%) ▪︎Spastic HemiPlegia (25%) ▪︎Spastic QuadriPlegia (20%) ▪︎Spastic ParaPlegia & MonoPlegia 📍2. DysKinetic CP (10-15%) ➡️ Results in Abnormal Movement & Involuntary Uncontrolled Recurrent Movements 📍3. Ataxic CP (<5%) ➡️ Results in Abnormal Posture & Movement & Loss Muscle Coordination Due To Cerebellar Injury 📍4. Dystonic CP ➡️ Results in Stiff Movements & Hypotonia & Reduced Activity (Floppy Infant) 📍5. ChoreAthetotic CP ➡️ Results in Combination Of Ataxia (Loss Balance & Coordination) & Rigidity (HyperTonia) & DysKinesia (Involuntary Movements) 📍6. Mixed CP (10-15%) ➡️ More Than One Pattern Of Motor Abnormality Present (More Complications)
🔷Clinical Features & Complications Of CP📍1. Feeding Difficulty 📍2. Developmental Delay 📍3. Abnormal Movements & Postures 📍4. Seizure Episodes 📍5. Behavioural & Sensory Abnormalities 📍6. Mental Retardation Or Learning Difficulties
🔷Mx Of CP📍1. Exclude Reversible Causes Of The Neurological Dysfunction (CT/MRI/Metabolic & TORCH Screen/Genetic Tests) 📍2. Evaluation Of Associated Abnormalities (Hearing & Visual Impairment/Seizures) 📍3. Physical & Occupational Therapy 📍4. Symptomatic Tx : ▪︎Sedatives ▪︎Muscle Relaxants ▪︎Surgical Correction Of The Deformities https://t.me/Clinicalpediatricround
