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07/10/2022


#سوال
کیا دانت نکلنے کے عمل کے دوران موشن اور بُخار ہو سکتا ہے ؟

#جواب
دانت نکلنے سے motion کا کوئی تعلق نہیں ہوتا -
6 ماہ کی عمر میں ہی دانت نکلنا شرو ع ہوتے ہیں اور یہی وہ وقت ہوتا ہے جب بچہ crawling بھی کرنا شرو ع کرتا ہے جس کی وجہ سے وہ ہاتھ منہ میں ڈالتا ہے اور جراثیم جسم کے اندر جانے کا زیادہ رسک ہوتا ہے اور اسی وجہ سے بچے کو motion لگتے ہیں ۔
مسوڑھوں میں خارش اور درد کی وجہ سے بھی بچہ ہر چیز منہ میں ڈالتا ہے اور motion لگ جاتے ہیں۔

28/09/2022
07/07/2022

بچوں میں خوراک کا چارٹ

پیدائش سے 4 ماہ تک
صرف ماں کا دودھ

4 ماہ سے 6 ماہ تک
ماں کے دودھ کے علاوہ دہی دیا جاسکتا ہے.

6 سے 8 ماہ تک
ماں کا دودھ، دہی، موسمی پھل، موسمی سبزیاں، دالیں اور چاول

8 ماہ کے بعد
پچھلی خوراک کے علاوہ انڈہ، گندم، گوشت قیمہ، مرغی، مچھلی بھی شامل کریں.
وقت کے ساتھ ساتھ خوراک بڑھاتے جائیں اور دودھ گھٹاتے جائیں یہاں تک کے ایک سال کی عمر پر آدھا کلو دودھ سے زیادہ دودھ نہ دیں. دودھ میں چینی اور شربت ہرگز شامل نہ کریں.

پانچ سال سے چھوٹے بچے کو چائے مت دیں.
شہد دیتے ہوئے خیال رکھیں کہ شہد بہت پرانا اور سٹورڈ نہ ہو. بہتر ہے کہ سال سے چھوٹے بچے میں شہد استعمال نہ کریں.

27/01/2022

Treatment of Cong hypothyroidism:

Levo thyroxine 10-15 micro gram /kg/day (50 micro for full term).
Rapid normalization within 2 wks.
Mixed with milk but not with soy, ca, iron. Avoid food for at least 30-60 min.

Monitoring:
T4 or free T4 every 1-2 month in first 6 month then 2-4 months bw 6m -3 yr.

After 3 yr trial of 4wk of stopping drug and see for raised TSH.
If normal --- 》 transient dis.
If raised---》 permanent hypothyroidism.

25/01/2022

Types of liver abscess:

PYOGENIC LIVER ABSCESS:
(Staph, streptococcus, E.coli klebsiella)

Fever, chills, pain, hepatomegaly (less common symptoms).
Leukocytosis, hypoalbuminemia, raised ALT.
Confirmed by blood culture and USG/ CT.
Treatment:
4-6 wk IV therapy.
If >5-7 cm --》 per cutaneous drainage is done.

# # # AMEBIC LIVER ABSCESS:
(E. Histolytica)

Fever, pain, wt loss, anorexia.
Leukocutosis without eosinophillia, raised ALT.
USG and CT and ELIZA.
Stool PCR, antigen detection are most sensitive and specific for diagnosis.
Treatment:
Nitromidazole 5-7 days.
If >5-7 cm aspirations done.

# # # HYDATID CYST (echinonoccosis):

Palpable mass, vomiting, pain hepatomegaly.
In lungs --》 cough,pain,hemoptysis.
Diagnosis:
USG/CT both show similar findings,
ELIZA is more specific and sensitive in hepatic cyst.
DD is benign hepatic cyst which is differentiated by absence of 3 distinct layer wall, internal membrane and hydatid sand.
Treatment:

19/01/2022

Most important and only CPSP highyield..
👇

HUMAN GENETICS 🧬

1. Karyotype of male Noonan ! = 46XY✓
2. Karyotype of Klinfilter Syndrome ! = 47XXY✓
3. Most common translocation of Down sumdrome! = 46XY(14:21)✓
4. Chromosome associated with fragile X syndrome != Xq27.3✓
5. A newborn who is SGA with epicanthal folds, edema hands ,webbing of neck and urine output 1 plus most likely diagnosis != Turner syndrome ✓
6. A neonate with rocker bottom feet , cleft palate, prominant occiput, narrow nose, pverlapping fingers, and premature appearance; likely != Edward syndrome✓
7. A child presented with coloboma, heart defects, atresia choanae, growth retardation, renal abnormalities and ear abnormalities. What will you do next != Karyotyping ✓
8- A 6 year old child presented with large ears and 20 ml te**es, initial test to do != Karyotyping ✓
9. What is inheritance if there are no skip generation amd male female are equally effected != Autosommal dominant. ✓
10.Male with breast enlargement is seen is != Klinfelter Syndrome✓
11. A neonate with Macroglosia and Omphalocele; Likely diagnosis != Beckwith-Weidman Syndrome ✓
12. What is karyotype a girl presenting with short stature, neck webbing and weaker pulses in legs or groin than it is in the arms of neck ? = 45 X✓
13. A child with large ear and te**es: likely diagnosis ? = Fragile X syndrome ✓
14. Chances of down syndrome in next pregnancy in 21/21 translocation ? = 100%✓
15. Retinitis pigmentosa and polydactyly are found in ? = Bardet- biedl syndrome✓
16. A 5 year child with down syndrome can ride tricycle and copy circle. What is developmental age ? = 3 years ✓
17. 24 year old have birth to Down baby with 21/21 translocation. What to do ? = Karyotyping of both parents ✓
18. A child presenting with macrosomia, hernia and fits. Likely cause ?= Beckwith Weidman syndrome ✓
19. A girl with turner syndrome came for growth hormone replacement. What will you do before starting treatment ? = Bone age ✓
20. A girl presented with abnormal behavior, inappropriate laughter, hand clapping and regression of milestones. What is the feature included in diagnostoc criteria ? = inappropriate laughing ✓
21. A child with dysmorphic facies , obesity, hypogonadism and mental retardation: likely cause ? = Parder willi Syndrome ✓
22. Obesity, retinitis pigmentosa and syndactyly are found in ? = Bardet - Biedl syndrome ✓
23. Gene involved in Parder willi Syndrome ? = P15 mutation ✓
24. A child with down syndrome has increased height and decreased weight. What test to be done ? = T4 and TSH ✓
25. A child presented with features of down syndrome. Her father has 21/21 translocation. What is recurrence risk ? = 100% ✓
26. A tall thin boy presented with gynecomastia and hypopigmentation. How to investigate ? = Karyotyping ✓
27. A short girl with primary amenorrhea, shield like chest and webbed neck. What to do next ? = karyotyping ✓
28. A child with history of FTT initially in infancy is now becoming overweight. He has short stature, almond shaped eyes and thin upper lip. What is best recommendation ? = Growth hormone ✓
29. Cause of fits with beckwith- Weidmann syndrome ? = Hypoglycemia ✓
30. For prenatal screening and diagnosis of down syndrome triple test is performed in ? = 16-18 weeks ✓


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