Pediatric Shelf Review Lecture

Introduction

• Lecturer: Devine, a fourth-year medical student.
• No financial disclosures.

Case Study: Sleep Terror Disorder

• Patient: 4.5-year-old male
• Symptoms: Agitation, tears, drowsiness, no memory of events
• Diagnosis: Sleep Terror Disorder
• Management: Reassurance (kids outgrow with time)
• Contrast with Nightmare Disorder: Memory of event, occurs during REM sleep

Case Study: Bruton's A-gamma Globulinemia

• Patient: 18-month-old male, recurrent pneumonia
• Symptoms: Recurrent bacterial infections, family history
• Diagnosis: Bruton's A-gamma globulinemia
• Cause: BTK gene mutation, B cell proliferation defect
• Treatment: IVIG

Immunodeficiency Syndromes Overview

• Bruton's A-gamma Globulinemia: X-linked, boys, recurrent bacterial infections
• SCID: Combined B and T cell problems, severe infections
• Wiskott-Aldrich Syndrome: Low platelets, eczema, X-linked
• DiGeorge Syndrome: T-cell deficiency, hypocalcemia, cardiac defects
• Others: IgA deficiency, ataxia telangiectasia, CVID

Case Study: Wilms Tumor

• Patient: 18-month-old female, abdominal mass, hypertension
• Diagnosis: Wilms Tumor
• Differentiation: Unilateral, non-calcified; Neuroblastoma tends to cross midline

Pediatric Infections and Disorders

• Lyme Disease: Treatment with amoxicillin for children <8 years
• Kawasaki Disease: Symptoms include conjunctivitis, rash, fever, treat with IVIG and aspirin
• Osteomyelitis: Common cause Staph aureus; Salmonella in sickle cell disease

Pediatric Rheumatological Conditions

• Juvenile Idiopathic Arthritis (JIA): Types include oligoarticular, polyarticular, systemic (Still's disease)
• Transient Synovitis: Recent URI, management with NSAIDs

Orthopedic Disorders

• Nursemaid Elbow: Radial head subluxation, treated with supination
• Developmental Dysplasia of the Hip (DDH): Hip click, treated with Pavlik harness
• Slipped Capital Femoral Epiphysis (SCFE): Overweight adolescents, surgical pinning required

Genetic and Metabolic Disorders

• Cystic Fibrosis: Autosomal recessive, chronic lung infections, pancreatic insufficiency
• Down Syndrome Associations: Hirschsprung's disease, duodenal atresia

Pediatric Cardiology

• Tetralogy of Fallot: Cyanotic spells, treat with surgery
• Transposition of Great Vessels: Egg on a string appearance
• VSD & ASD: Common congenital defects

Miscellaneous

• Vaccinations: Avoid live vaccines in immunocompromised
• Pediatric Seizures: Febrile seizures, typical vs atypical
• Newborn Jaundice: Physiologic vs pathologic, phototherapy for indirect hyperbilirubinemia

Conclusion

• Review high-yield topics for pediatric exams, understand pathophysiology, and management of common pediatric conditions.