Introduction to Growth & Development Part 2

 

4. NERVOUS SYSTEM

1. Cerebral palsy: general features

PALSY:

• Paresis
• Ataxia
• Lagging motor development
• Spasticity
• Young

2. Cerebral palsy (CP): most likely cause

• CP: Cerebral Palsy
• Child Premature

3. Cerebral Palsy: Types

SADAM

Spastic (Increase tone)

Athetoid/Diskinetic (Involuntary & uncontrolled movements)

Ataxic (cerebellar  damage with fine motor skills & balance difficulty)

Mixed

4. Clinical Presentation of brain tumors: Sign & symptoms

BAHENNS

• Blurring of vision
• Ataxia
• Headache
• Endocrine dysfunctions
• Nystagmus
• Nausea & vomitting
• Squint

5. Dandy-Walker syndrome: components

"Dandy-Walker Syndrome":

• Dilated 4th ventricle
• Water on the brain
• Small vermis

6. Fetal alcohol syndrome (FAS): features

FAS:

• Facial hypoplasia/ Forebrain malformation
• Attention defecit disorder/ Altered joints
• Short stature/ Septal defects/ Small I.Q

7. Sturge-Weber syndrome: hallmark features

Sturge-Weber:

• Seizures
• PortWine stain

8. WAGR syndrome: components

WAGR:

• Wilm's tumor
• Aniridia
• Gential abnormalities
• Mental retardation

9. Williams syndrome: features

WILLIAMS:

• Weight (low at birth, slow to gain)
• Iris (stellate iris)
• Long philtrum
• Large mouth
• Increased Ca++
• Aortic stenosis (and other stenoses)
• Mental retardation
• Swelling around eyes (periorbital puffiness)

5. CARDIOVASCULAR SYSTEM

1. Cyanotic congenital heart diseases: 5 types

5 T's:

• Truncus arteriosus
• Transposition of the great arteries
• Tricuspid atresia
• Tetrology of Fallot
• Total anomalous pulmonary venous return

2. Cyanotic heart diseases: 5 types

 *Use your five fingers:

• 1 finger up: Truncus Arteriosus (1 vessel)
• 2 fingers up: Dextroposition of the Great Arteries (2 vessels transposed)
• 3 fingers up: Tricuspid Atresia (3=Tri)
• 4 fingers up: Tetralogy of Fallot (4=Tetra)
• 5 fingers up: Total Anomalous Pulmonary Venous Return (5=5 words)

3. Tetrology of Fallot

"Don't DROP the baby":

• Defect (VSD)
• Right ventricular hypertrophy
• Overriding aorta
• Pulmonary stenosis

4. Vacterl syndrome: components

VACTERL:

• Vertebral anomalies
• Anorectal malformation
• Cardiac anomaly
• Tracheo-esophageal fistula
• Exomphalos (aka omphalocele)
• Renal anomalies
• Limb anomalies

6. RESPIRATORY SYSTEM

1. Cough (chronic): differential

When cough in nursery, rock the "CRADLE":

• Cystic fibrosis
• Rings, slings, and airway things (tracheal rings)/ Respiratory infections
• Aspiration (swallowing dysfunction, TE fistula, gastroesphageal reflux)
• Dyskinetic cilia
• Lung, airway, and vascular malformations (tracheomalacia, vocal cord dysfunction)
• Edema (heart failure)

2. Croup: symptoms

3 S's:

• Stridor
• Subglottic swelling
• Seal-bark cough

3. Cystic fibrosis: exacerbation of pulmonary infection

CF PANCREAS:

• Cough (increase in intensity and frequent spells)
• Fever (usually low grade, unless severe bronchopneumonia is present)
• Pulmonary function deterioration
• Appetite decrease
• Nutrition, weight loss
• CBC (leukocytosis with left shift)
• Radiograph (increase overaeration, peribronchial thickening, mucus plugging)
• Exam (rales or wheezing in previously clear areas, tachypnea, retractions)
• Activity (decreased, impaired exercise intolerance, increased absenteeism)
• Sputum (becomes darker, thicker, and more abundant, forming plugs)

4. Cystic fibrosis: presenting signs

CF PANCREAS:

• Chronic cough and wheezing
• Failure to thrive
• Pancreatic insufficiency (symptoms of malabsorption like steatorrhea)
• Alkalosis and hypotonic dehydration
• Neonatal intestinal obstruction (meconium ileus)/ Nasal polyps
• Clubbing of fingers/ Chest radiograph with characteristic changes
• Rectal prolapse
• Electrolyte elevation in sweat, salty skin
• Absence or congenital atresia of vas deferens
• Sputum with Staph or Pseudomonas (mucoid)

7. GASTROINTESTINAL SYSTEM

1. Duodenal atresia vs. Pyloric stenosis: site of obstruction

• Duodenal Atresia: Distal to Ampulla of vater.
• Pyloric stenosis: Proximal to it.

2. Gastroschisis: usual location

• GasTRoscHIsis usually occurs on the
• RIGHT side of the umbilicus.

(Unscramble the letters).

3. Pyloric stenosis (congential): presentation

Pyloric stenosis is 3 P's:

• Palpable mass
• Paristalsis visible
• Projectile vomiting (2-4 weeks after birth)