Patho common pediatric and childhood disorders

most common motor disability in childhood

cerebral palsy

usually caused by abnormal brain development, can be damage to the white matter as a result of reduced oxygen supply – manifests as a disorder of movement, muscle tone, coordination

down syndrome

result of abnormal cell division results in an extra full or partial copy of chromosome 21

Turner syndrome

monosomy X

affects females, they often have short stature and infertility

Klinefelter syndrome

XXY

males will have infertility

atopic dermatitis

most common form of eczema in children

distribution of atopic dermatitis in children

young: rash to face, scalp, trunk, arms, and legs

older: rash to neck, antecubital and popliteal fossae, hands, and feet

Impetigo contagiosum

bacterial infection of the skin caused by staphylococcus aureus

classic presentation is honey-colored lesions

molluscum contagiosum

highly contagious viral infection of the skin with small raised lesions with a dimple in the center

Rubella (German or 3-day measles) manifestations

Enlarged cervical and postauricular lymph nodes, low-grade fever, headache, sore throat, runny nose, cough, faint pink-to-red maculopapular rash caused by virus dissemination to trunk and extremities

Rubeola (measles) manifestations

Koplik spots are small white spots that occur on the inside of the cheeks in the early course of the measles. Begins on face and spreads down

Roseola (6th disease) manifestations

Rash may appear as small pink spots – patient is only contagious for 1 or 2 days after fever subsides, even if rash is still present. Rash starts on the torso and spreads out

Chickenpox (Varicella)

Produced by the varicella-zoster virus (VZV),

*First signs of illness include fever, itching, and appearance of vesicles on face, trunk, or scalp

5th disease (erythema infectiosum)

caused by Parvovirus B19

manifested by a Facial rash that looks as though cheeks were slapped. Contagious for 7-10 days before the rash appears, no longer contagious once rash appears

Coxsackie virus (hand, foot, and mouth)

•Symptoms include fever, rash on palms and soles of feet, mouth sores (1-2 after fever starts) sore throat, joint pain, headaches and can last for 7-10 days

rash is usually flat, red sports, but sometimes blister

Which of the following skin infections is caused by a fungus?

A. Impetigo    

B. Rubella

C. Tinea capitis

D. Chickenpox

•Correct Answer: C

•Impetigo is a contagious bacterial disease. Rubella is a communicable viral disease. Tinea capitis and tinea corporis are fungal infections. Chickenpox (varicella) is a highly contagious disease caused by the varicella-zoster virus.

patent ductus arteriosus

congenital heart defect where the fetal artery that connects the aorta to the pulmonary artery does not close. You will find a continuous machinery type murmur

Atrial Septal defect

congential heart defect where there is a hole between the left and right atrium. You will hear a loud harsh murmur with a fixed split-second heart sound

Ventricular Septal Defect

congential heart defect where there is hole between the left and right ventricle. You will hear a loud harsh murmur at the left sternal border.

tetralogy of fallot

cyanotic congential heart defect that consists of 4 defects  1) Pulmonary Stenosis   2) VSD  3) Overriding aorta  4) Right ventricular hypertrophy

heart failure in infants and children

Heart Failure occurs in 30% of children with congenital heart defects

Due to Volume Overload, Pressure Overload, and Dysfunction of cardiac muscle

s/sx of congenital heart disease

cyanosis, tachypnea, tachycardia, nasal flaring, irritability, lethargy, poor feeding, failure to thrive

Kawasaki disease

•Affects the skin, brain, eyes, joints, liver, lymph nodes, and heart

•There is vasculitis in the small vessels and progresses to involve some of the larger arteries including coronary

acute phase of kawasaki disease

•fever, conjunctivitis, rash, involvement of the oral mucosa, redness and swelling of the hands and feet, and enlarged cervical lymph nodes

subacute phase of kawasaki disease

defervescence (return to normal body temp) and desquamation (shedding outer layers of the skin)

convalescent phase of kawasaki disease

•complete resolution of symptoms until all signs of inflammation have disappeared after about 8 weeks

most common viral cause of gastroenteritis

norovirus

most common bacterial cause of gastroenteritis

E. coli

manifestations of gastroenteritis

rapid onset of diarrhea lasting 2-4 days, but usually not more than 1 week

N/V can last 1-2 days

asthma pathophysiology

airway inflammation

bronchial hyperresponsiveness

acute reversible bronchoconstriction

note, you may see pulsus paradoxus (diminshed pulse during inspiration)

Bronchiolitis

acute inflammatory injury of the bronchioles that is usually caused by RSV

Croup

upper airway infections where you will see stridor and slight dyspnea

parainfluenza viruses account for majority of cases

Epiglottitis definition and manifestations

inflammation of the epiglottis most commonly caused by H. Influenza B

Child can be pale, lethargic, sitting up with mouth open and chin thrust forward – neck is extended (this is called tripoding),  Has difficulty swallowing, muffled voice, drooling, fever and extreme anxiety. Stridor, flaring of nares, and inspiratory retractions

Type 1 DM classic triad and other manifestations

polyuria, polydipsia, polyphagia

weight loss, fatigue, may see return of bed-wetting in potty trained children

Believed to be caused from autoimmune-mediated loss of beta cells in pancreatic islets, so there is no production of insulin

complications of metabolic syndrome

•Hypertension

•Type 2 diabetes

•Coronary artery disease

•Stroke

•Kidney failure

•Significantly shortened life expectancy

Juvenile Rheumatoid Arthritis

disease that is autoimmune in nature that causes joint swelling or discomfort that lasts more than 6 weeks

anorexia nervosa

•Results in severe malnutrition, protein and vitamin deficits

•Anorexic person appears emaciated (thin and wasted)

•Lack of menstrual cycles - amenorrhea

•Low body temperature – cold intolerance

•Low blood pressure and slow heart rate

•Dry skin and brittle nails

•Development of fine body hair

•Low calcium intake – predisposition to osteoporosis later in life

•Dehydration affecting kidney and cardiovascular function

•Electrolyte imbalances can cause cardiac arrhythmias and cardiac arrest.

Anorexia can be LIFE-THREATENING

bulimia nervosa

Characterized by binge eating, followed by self-induced vomiting (purging)

Excessive use of laxatives and diuretics

Compulsive exercising

May see erosion of tooth enamel, tears or ulcers in oral mucosa, esophagitis with sore throat and difficulty swallowing (result of self-inducing vomiting).

inflammatory vs non inflammatory acne

Non-inflammatory acne:

•Formation of Comedones: Whiteheads (closed) or blackheads (open)

Inflammatory

•Papules, pustules, nodules, and, in severe cases, cysts

•Believed to develop from the escape of sebum into the dermis and the irritating effects of the fatty acids contained in the sebum

• Caused by follicular wall rupture in closed comedones

•Cystic nodules develop when inflammation is deeper

Infectious Mononucleosis

caused by the Epstein-Barr virus

incubation period is 4-6 weeks

Manifestations: Sore throat, headache, Fever, Fatigue, malaise, Enlarged lymph nodes and spleen, Rash on the trunk, Increase in lymphocytes and monocytes in blood, Atypical T-lymphocytes, Positive heterophil antibody test

*must be careful during contact sports d/t enlarged spleen