小兒科day two雜記

Pediatrics 小兒科day two雜記

1. Ｈow to estimate the target height of a kid?

boy: (father's height+mother's height +12)/2 
girl: (father's height+mother's height -12)/2 

2. Precocious puberty for Caucasians

boy: <9, testis, pubic hair

girl: <8, breast, MC, pubic hair

pubic hair growth: pubarche

breast budding: thelarche

Tanner score

 

3. Pediatric asthma attack

-- IM epinepherine

-- IV hydrocortisol

-- Inhale Ventolin (fast!)

4. VACTERL 

Vertebral defects

Anal atresia

Cardiac defects

Tracheo-esophageal fistula

Renal anomalies

Limb abnormalities

5. Causes of conscious change

A-- Alcohol, anemia
E-- Electrolyte imbalance
I--  Insulin
O-- Opiates, oxygen
U-- Uremia

T-- Trauma, temperature, tumor
I--  Infection, inflammation
P-- Psychogenic
S-- Seizure, stroke

When applied on kids, mind trauma and encephalopathy(ex. anti-NMDA receptor encephalitis) 

5. Ｃatatonia: Over 3 points(+) among 12 symptoms

Symptoms--
Catalepsy, Waxy flexibility, Stupor, Agitation, Mutism, Negativism, Posturing, Mannerism, Stereotypes, Grimace, Echolalia, Echopraxia

Treatment--
BZDs

6. CKD complications

-- anemia

-- secondary hyperparathyroidism

-- shorter stature and lagging development

7. Post-transplantation(kidney) graft dysfunction

-- within 1 wk (after transplantation): rejection
-- within 1~12 wks :                            drug-related= CIN(ex. Tacrolimus)
-- within 3 months:                             chronic change, unknown causes

8. RTA (acidosis without gap)

--type 1: distal tubules, low K+, FeHCO3- <3. calcinosis; ex. Fanconi's syndrome, SSr, RA, SLE

--type 2: proximal tubules, low K+, FeHCO3- >15; ex. SLE, MM, WM

--type 4: RAS system down, high K+, FeHCO3- <3; ex. DM

9. JOUBURT syndrome

--  absence or underdevelopment of the cerebellar vermis

10. Febrile convulsion

-- More commin during 6 months ~ 5 y/o

-- Fever, generalized/symmetrical seizure; may use antipyretic when >38‘C

-- Symptoms relieved after several minutes (shorter than real seizures)

-- Do not have frequent recurrent episodes

-- DDx: seizure, trauma-induced, brain lesions, meningitis

11. Acytelcysteine indications

--  CIAKI : 1200mg BID (doubled!)

--  Expectorants

--  NAC intoxication

12. Trental (Pentoxyfylline) indications

--  PAOD

--  DM nephropathy

--  AIH???

13. Advanced glycation end-product

--proteins or lipids that become glycated as a result of exposure to sugars

14. Trenckhoff tube: two cuffs, for PPD

15. ESRD common causes in children

--  congenital defects 

--  UVR

--  GN( FSGN)

Relative rare causes: chemotherapy( cisplatin ), SLE