Oxygen-Pediatry

2021-12-11 19:55:44 Channel content:

Lecture 1: Growth monitoring and Anthropometric measurements

Lecture 2: Developmental milestones and assement

Course: how to interpret Growth indicators

Lecture 3: Shock

Lecture 4: Fluids and electrolyte imbalance Open / Comment

2021-09-03 19:05:59 السلام عليكم ورحمة الله وبركاته.
مرحباً بكم في Medical Corner

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#شير_عشان_الكل_يستفيد Open / Comment

2021-07-21 17:10:49 Summary
Pancytopenia can be due to bone marrow failure or bone marrow infiltration.
The most important risks from pancytopenia are bleeding and infection. Open / Comment

2021-07-21 17:07:07 !Investigation of pancytopenia

Blood film – detailed morphology of all cell lines
Red cell indices – the anaemia in AA is normocytic or mildly macrocytic
Reticulocytes –<20 10^9/L suggests severe aplastic anaemia
Viral titres – hepatitis, Epstein–Barr, parvovirus (usually causes red cell aplasia)
Chromosomes for breakage analysis
BM aspirate and trephine – to assess morphology and cellularity of the cells and to exclude infiltration. In AA it is hypocellular but the remaining cells are normal Open / Comment

2021-07-21 16:57:39 ! Differential diagnosis of pancytopenia

Bone marrow failure
Inherited – all rare. Commonest is Fanconi’s anaemia. Excess chromosome breaks. Defective DNA repair, decreased cell survival and susceptible to oxidant stress. Associated physical abnormalities, e.g. skeletal (absent thumbs), short stature. Only cure is a BM transplant.
Acquired– viral, e.g. hepatitis, herpes, Epstein–Barr– drugs – idiosyncratic, e.g. chloramphenicol, anticonvulsants, or predictable, e.g. chemotherapy; > 80 per cent are ‘idiopathic aplastic anaemia’.

Bone marrow infiltration
Malignancy, e.g. leukaemia or neuroblastoma. Rarely myelofibrosis and myelodysplasia. Open / Comment

2021-07-21 16:51:48 Questions: What is the differential diagnosis? What investigations are indicated? What are her major current risks? Write you answer in the group comment Open / Comment

2021-07-19 20:24:38 Questions:
What is the differential diagnosis?
What investigations are indicated?
What are her major current risks?

Write you answer in the group comment Open / Comment

2021-07-19 20:22:08 Investigation Open / Comment

2021-07-19 20:20:14 History
Sarah is a 4-year-old girl who is referred to the paediatric day unit by her GP with a 2-day history of widespread bruising. She has also had two nosebleeds in the preceding 24 hours.There are no known injuries, although her mother says she is quite ‘hectic’, especially when playing with her younger brother. They both had a cold and a sore throat 2 weeks previously. She is otherwise very well. There is no significant past medical or family history and she is on no medication.

Examination
Sarah is drawing pictures and is cheerful and cooperative. She has no dysmorphic features. Her height and weight are on the 25th centiles. There is no jaundice and she is afebrile.She is pale and clinically anaemic with a few 1.0 cm lymph nodes in the cervical and inguinal regions. There is widespread bruising mainly on her limbs but no evidence of active bleeding. There is no hepatosplenomegaly. Her pulse is 96 beats/min and both heart sounds are normal. She has a grade 2/6 ejection systolic murmur. Examination of the respiratory system is normal. Open / Comment