Important knowledge

⚡️Neonatal hypoglycemia

Neonatal hypoglycemia : --Defined as plasma glucose 30 mg /dl to 45 mg/dl or whole blood glucose 25 mg /dl to 40 mg /dl . --Most common causes are maternal diabetes and prematurity. -- measured in first hour of life then hourly for 6-8 h . --Tx : mild hypoglycemia =only early feeding  . Plasma glucose less than 20 mg/dl or blood glucose less than 25 mg /dl must treated immediately with iv infusion of glucose  4_8 mg / kg / min . Asymptomatic hypoglycemia closely monitored with early feeding if feeding intolerated or the baby becomes symptomatic give iv glucose. (((Give infusion notttttt boluse of glucose to avoid hyperinsulinemia that leads to rebound hypoglycemia))))

⚡️Neonatal examination (as simple ) ----------------------------------------------------------- 1- vitals ▪︎temperature ▪︎RR (40-60/min) ▪︎BP (in 4 extremities) ▪︎PR (100-180/min) 2 Anethropometric ▪︎length ▪︎wieght ▪︎OFC 3- 4 colors ▪︎red = conjunctivitis ▪︎yellow = jaundice ▪︎pale = anemia ▪︎ blue = cynosis 4 - 3 orifices ▪︎nose = coanal atresia , esophagial atresia ▪︎mouth = cleft palate , natal teeth ▪︎anus = imperforated anus 5 - diaper area ▪︎genetelia ( undesended testes, ambiguous genetelia ) ▪︎back (spina pifida , sacral agenesis ) ▪︎anus (do not miss it ) 6 - birth injury ▪︎head (capput succedanum , cephalohematoma) ▪︎moro reflex (erb's palsy ,Clavicle fracture ,humeral fracture, sholder dislocation) ▪︎Barlow test & Ortolani test (DDH) 7- reflexs ▪︎moro reflex (do not miss it ) ▪︎rooting reflex ▪︎sucking reflex

Up slanting eye

Down slanting eye

Neonatal examination

⚡️otitis media +diarrhea = paranteral diarrhea

⚡️don't miss to examine the axial tone in tone examination

⚡️In case of pneumonia & meningitis we don't give the full maintenance dose of fluid , we give only 2/3 of dose due to risk of SIADH

⚡️Epilepsy + neuro developmental delay = epileptic encephalopathy

⚡️اذا شفنا delay بال mile stone نرجع ليورة نسال على الشغلات الي قبلها حتى نعرف كل شغلة شوكت بدت عندة (د. خالد )

⚡️المشي يعتبر delayed بعد ال 18 months

⚡️mile stone of 5 years old age (د باسل ) - skips (يقطع خطوات عن طريق القفز) - يدكم ملابسة - ينزع ويلبس وحدة - يوكل نفسه

⚡️Encephalitis vs meningitis Encephalitis is assotiated with decreased level of conscious

⚡️causes of fit in gastroenteritis ▪︎hypoglycemia ▪︎hypo or hypernatremia ▪︎hypomagnesemia ▪︎hypocalcemia ▪︎fever ▪︎shiga toxin ▪︎stroke (due to dehydration ) ▪︎meningitis ( GE may present as a prodromal period of CNS infection like meningitis )

⚡️The preferred site for obtaining bone marrow in children is the posterior superior iliac crest ( lower back ) [so should differentiated from LP in history ]

⚡️leukemia don't occur before 6 month age

⚡️head control occour in 3 months of age ( د باسل )