Pa ed i a t r i c M n emo n i cs

***

T r a n si en t Ta ch y pn ea o f t h e N ew bo r n is the commonest cause of

Respiratory Distress in T er m infants.

***

Go w eR’s si gn is indicative of weak Pelvic Gi R d l e & hip

muscles.

***

MT i ochondrial DNA mutations show only MT

a ernal transmission.

***

Investigations used 4 antenatal diagnosis of:

TR isomy 21:
‫ـــــــــــــــــــــــــــ‬

TR iple Test.

Nuchal TR anslucency scan.

TR ans-abdominal Amniocentesis & Chorionic villus sampling.

***

Common features of Trisomies we've in our curriculum:

Trisomy = EXTRA C R h omosome.

 Remember that all trisomies have in common:

EXTR emity Malformations (Hands & feet).

C ardiac Malformations.

R enal Malformations.

***

Extremity malformations in Trisomies:

- Down:

S i m i a n crease.

S a n d a l gap.

- Edward:

C l en ch ed h a n d s with overlapping fingers.

C
o n v ex bo t t o m o f t h e f eet with Prominent calcaneus (Rocker-bottom

feet).

- P atau:

P o l y d a ct y l y

***
 And a little clinical reminder;

Whenever U get to a case of Abdomen;

Remember that :

Abdomen is a BA G (carrying the viscera !)

So, Don't 4get to examine The BA ck

Once the diagnosis is suspected, a large nasogastric tube is passed and

“suction” is applied to prevent distension of the intrathoracic bowel.

***

In Intussusception;

Radiographic Reduction is contraindicated in cases with:

P er f o r a t io n

Or conditions Predictive of perforation; e.g.

P er it o n it is

Henoch-schonline Pu r pu r a

***

Co n t r a st –en h a n ced X-Ray may show:

Co i l -spr i n g appearance.
 C l a w si gn

***

D i sea ses i n w h i ch I V I g ca n be u sed :

I TP

Ka w a sa k i D i sea se

Gu i l l i a n Ba r r e

***

Regarding A n a ph y l a x i s;

Risk factors for fatal outcome include:

A d o l escen t age group

Coexistent A st h m a
A l l er gy t o Nuts
***

Acute Management is early administration of:

IM A d r en a l i n e
***

Complications of Long-term Blood Transfusion

I r o n overload & Hemosiderosis

 I I
so - m m u n e reactions

I n f ect i o n s

***

Regarding Sickle cell anemia;

To Remember which Amino Acid replaces which,

V LI E
A N reminds you of EV I L
G l u t a m i c a ci d reminds you of G doo

So, when Evil replaces Good, Disease occurs.

When Valine replaces Glutamic acid, Sickle cell anemia occurs.

***

Regarding F e-deficiency anemia;

Let t er F is the 6 th alphabetically,

This gives a clue to important points in Oral Iron Therapy;

Dose: 6 mg\Kg\ day.

Course: 6 Weeks after normalization of all blood values to replete the stores.

***

In Fallot’s Tetralogy
 Hypercyanotic Sp el l s are due to

Infandibular Sp a sm

***

Hypercyanotic spells are usually self-limiting, but if prolonged (> 15 minutes), the
child should be admitted to the

H O SPI TA L
To receive:

IV H y dr a t io n

O 2

S ed a t i o n & pa i n r el i ef (M o r ph i n e)

S o d i u m Bi ca r bo n a t e

P r o pr a n o l o l

I r on T h er a py

A ssi st ed V en t i l a t i o n (i f n o i mpr o v em en t )

***
 The 2 Master Keys to MCNS are 2 S
S el ect i v e Proteinuria

S t er o i d -sensitivity

***

Investigations for Bronchial Asthma:

Bronchial Asthma

Hypersensitivity Reaction ( A n t i gen + A n t i bo d y )

COPD (d ef ect i v e O x y gen a t i o n + A i r w a y O bst r u ct i o n )

So

Investigations are directed towards detecting:

A n t i gen (Skin Tests)

A n t i bo d y (IgE) (Total & specific)

-- O x y gen a t i o n (Pulse Oximetry)

Air w a y O bst r u ct i o n (PEFR) (Peak Expiratory Flow Rate)

 ***

Regarding Investigations of CV S Diseases;

3 C ’s

1- Investigations for the C o n d i t i o n itself:

- Anatomical:

C h a m ber Enlargement. (Chest X-ray + Echo)

Pulmonary V a scu l a t u r e. (Chest X-ray)

S Site & ize of the Defects. (Echo)

- Functional:

- C o n t r a ct i l i t y . (Echo)

- V el o ci t y of conduction & Rhythmicity. (ECG)

Flow directions & Pressure Gradients across the defects. (Echo with Color flow
Doppler + Cardiac catheterization).

***

2- Investigations for C o m pl i ca t i o n s (As in Fallot)

 e.g. Brain Abscess or infarction: CT scan & MRI Brain.

***

3- Investigations for C A u se & a sso ci a t i o n s (As in Rheumatic fever)

e.g. ASO Titer & Acute phase reactants.

***

Investigations for

Anemia

St a t e it’s Anemia. (CBCwith Retics)

1- To

2- To Su r v ey if it’s Hemolytic & Iron deficiency. (Blood Chemistry:

Serum Iron, Serum Ferritin, Serum TIBC, Serum Bilirubin)

spo t abnormal Morphology. (Blood Film)

3- To

4- To spo t abnormal Hb (Hb Electrophoresis)

5- To spo t abnormal Enzyme (G6PD Level in Favism)

6- Speci a l Test s for special Types. (Sickling Test for Sickle cell

anemia – Osmotic Fragility test for Hereditary Spherocytosis)

+
I n v est i ga t i o n s f o r co m pl i ca t i o n s a s i n si ck l e cel l a n em i a

***

dr R.M