Oral stations Year 4 Paediatrics Notes OmpathStudy

Oral stations Year 4 · Paediatrics Collection: 4TH YEAR ALL NOTES / PAEDS / PAEDS REVISION -- Pediatric oral stations Guide Table of contents: Sessions’ ​materials​:\nDiarrhea and vomiting, management of dehydration(Gastroenteritis and dehydration)……………​2\nApproach to wheezing (bronchiolitis) & stridor in children……………………………………………………....​7\nShort stature, Growth charts and nutritional history………………………………………………………………​12\nApproach to Febrile convulsions……………………………………………………………………………………....……​17\nApproach to fever in neonates, meningitis, UTI and immunization history……………………...……....​19\nApproach to neonatal jaundice and perinatal history……………………………………………………… ….….​27\n\nTopics from the list: Hepatosplenomegaly 31 Abdominal mass 43 Adrenal insufficiency 54 Anemia 33 Development assessment. 45 Heart failure 56 Asthma 35 Skin rash 46 Vitamin D and calcium disorders 58 Premature baby 37 Hematuria 49 Joint pain 60 RDS ​and​ cyanotic child 39 Nephrotic syndrome 51 Hypotonic child 62 Abdominal pain 41\n\n ​Done by​...................\n❤ Rawan aldhuwayhi\n❤ Nouf Altwaijri\n❤ Asrar Batarfi\n❤ Norah Alromaih\n❤ Luluh Alsughayer\n❤ Monerah Alsalouli \n\n Diarrhea and vomiting\nmanagement of dehydration Objectives:\n● Summarize an approach to evaluate a child with diarrhea\n● Summarize an approach to evaluate a child with vomiting\n● Discuss principles of maintenance IV fluids\n● Describe clinical signs and types of dehydration\n● Discuss principles of fluids management (deficit and ongoing losses) of different types of dehydran.\n\n Diarrhea in infant and children CASE: 18 month old infant came to the clinic with diarrhea. Other point in the history is irrelevant. On clinical examination his growth in on the 10th percentile. He has mild pallor and mild abdominal distention. What is your clinical approach to this case? Introduction:\n● Diarrhea is frequent loose or watery bowel movements that deviate from a child’s normal pattern.\n● Diarrhea may be accompanied by anorexia, vomiting, acute weight loss, abdominal pain, fever, or\npassage of blood. If diarrhea is severe or prolonged, dehydration is likely. Even in the absence of\ndehydration, chronic diarrhea usually results in weight loss or failure to gain weight. Pathophysiology:\n● Osmotic ​diarrhea results from the presence of nonabsorbable solutes in the Gl tract, as with lactose\nintolerance. Fasting for 2 to 3 days stops osmotic diarrhea.\n● Secretory ​diarrhea results from substances (eg, bacterial toxins) that increase secretion of chloride\nions and water into the intestinal lumen. Secretory diarrhea does not stop with fasting.\n● Inflammatory ​diarrhea is associated with conditions that cause inflammation or ulceration of the\nintestinal mucosa (eg, Crohn disease, ulcerative colitis). The resultant outpouring of plasma, serum\nproteins, blood, and mucous increases fecal bulk and fluid content.\n● Malabsorption ​may result from osmotic or secretory mechanisms or conditions that lead to less\nsurface area in the bowel. Conditions such as pancreatic insufficiency and short bowel syndrome and\nconditions that speed up transit time cause diarrhea due to decreased absorption. Some causes of diarrhea:\nCause Suggestive findings Diagnostic approach Acute Viruses gastroenteritis ​(eg, astrovirus, <5 days of diarrhea with no blood Often Clinical evaluation calicivirus, enteric adenovirus, ​rotavirus​) vomiting Possibly fever Contact with the most common cause of diarrhea infected people Appropriate season for the\ninfection Antibiotics (eg. broad spectrum antibiotics, Temporal relationship of taking of Clinical evaluation multiple concomitant antibiotics) antibiotics Bacteria ​(eg, campylobacter sp, E.coli[can Fever, bloody stool, abdominal pain, Stool culture cause Hemolytic uremic syndrome], possibly petechiae or pallor (in patients with Fecal leukocytes salmonella sp, Shigella sp, Yersinia hemolytic uremic syndrome). If patients appear ill, CBC, renal function enterocolitica) History of contact with animals (E.col) or test, and blood culture.\nreptiles (salmonella). If a patient has recently been given\nRecent (<2mo) antibiotics use (C.difficile). antibiotics stool testing for C.difficile toxin.\nDay care center outbreak. \n\nFood allergy​ or food poisoning Allergy: ​Urticarial rash, lip swelling, Clinical evaluation\nabdominal pain, vomiting, diarrhea, difficulty\nbreathing within minutes to several hours\nafter eating\nPoisoning: ​Nausea, vomiting, abdominal\npain, diarrhea several hours after ingestion\nof contaminated food Parasites​ (​ eg, Giardia intestinalis (lamblia), Abdominal bloating and cramping, Microscopic examination of stool for ova Cryptosporidium parvum) foul-smelling stools, anorexia Possibly and parasites Stool antigen tests\nhistory of travel, use of contaminated water\nsource Chronic Hirschsprung enterocolitis Delayed passage of meconium​ 48 h Rectal biopsy​ diagnostic!\nafter birth.\nPossibly long-standing history of\nconstipation Bilious vomiting