AdrPlexus Additional Images File In Pediatrics

Tricks For Solving Difficult IEM Storage Disease MCQS

AdrPlexus Revision File- Additional Tables For Extra- Boost In Pediatrics!

Queries From Students Post-Class & Additional Information For Revision

An Approach To A Neonate With Persistent Vomiting- Workbook Flowchart

Decorticate Vs Decerebrate Posturing

 • Both arise due to compression/involvement of descending tracts from brainstem
• Lesions proximal to red nucleus produce decorticate posturing
Normally, the rubrospinal tract starts from the red nucleus and descends as far as the
thoracic spine, it, therefore, has effects on the upper limbs but not lower. The red
nucleus, via the rubrospinal tract, causes a flexion, grasping type reflex of the upper
limbs. The higher brain centers, such as the cerebral cortex, inhibit this reflex during
normal physiology. With a lesion of the corticospinal tract, the red nucleus is
disinhibited, and the flexion reflex of the upper limbs occurs. Additionally, the
vestibulospinal tracts, are also left disinhibited, and extension of the lower limbs occurs.
This flexion of the upper limbs and extension of lower limbs is decorticate posturing.

• Lesions at or distal to red nucleus produce decerebrate posturing

In isolation, the vestibular nucleus, via the vestibulospinal tract, causes activation of
extensor motor neurons in the spinal cord and inhibition of flexor motor neurons. Under
normal physiology, the higher brain centers of the cortex and cerebellum inhibit the
vestibular nuclei, thus preventing this reflex. Decerebrate posturing results from a
disconnection between the modulatory higher centers and the vestibular nuclei,
resulting in unsuppressed extensor posturing.

Chorea Vs Athetosis Vs Hemiballismus

• Chorea is characterized by repetitive, brief, irregular, somewhat rapid
involuntary movements that start in one part of the body and move abruptly,
unpredictably, and often continuously to another part. Chorea typically involves
the face, mouth, trunk, and limbs.
• Athetosis is a continuous stream of slow, flowing, writhing involuntary
movements. It usually affects the hands and feet.
• Hemiballismus is a type of chorea, usually involving violent, involuntary flinging
of one arm and/or one leg. Movements are wider and more intense than
chorea.
Nutritional Recovery Syndrome Vs Refeeding Syndrome
• Both are complications SOMETIMES seen during recovery from SAM
• Nutritional Recovery Syndrome, also called Gomez Syndrome, occurs during rehabilitation
phase, due to high protein in diet. Produces Ascites, hepatosplenomegaly, hypertrichosis,
gynecomastia, parotid swelling and eosinophilia with prominent veins on the anterior
abdominal wall. Hormonal imbalance may be causative. Responds to protein restriction
• Refeeding Syndrome is seen when too-high calories are started during SAM rehabilitation.
Hyperglycemia, Hyperinsulinemia and Hypophosphatemia are seen. It can cause CCF-like
symptoms or seizures with hemolysis. Responds to gradual energy hike & phosphate
supplementation.

Genetic Rickets- Key Clinical Features To Remember

• VDDR-1: Similar to nutritional rickets. Can have symptoms of hypocalcemia also.
• VDDR-2: Early onset of rickets, a high prevalence of alopecia and ectodermal defects
(oligodontia, milia and epidermal cysts) are characteristic.
• X-Linked hypophosphatemic rickets: Lower limb deformities, Dental abnormalities are
commonly seen including pulp deformities with intraglobular dentin, and frequent dental
abscesses.

Tourette Syndrome & Tics- What is the difference?

Tourette Syndrome is characterized by onset before 18 years of age, presence of both motor and
vocal tics and persistence beyond 1 year, including the waning phase.