Pediatric Shelf Review Lecture Notes

Introduction

• Presenter: Devine, 4th-year medical student
• Focus on pediatric disorders and high-yield exam topics

Sleep Disorders in Children

• Sleep Terror Disorder
  • Agitation and tears at night, no memory next morning
  • Occurs in N3 stage of sleep, reassurance as treatment
  • Differentiate from nightmare disorder (occurs during REM, remembered)

Immunodeficiency Disorders

• Bruton's Agammaglobulinemia
  • X-linked, affects boys, recurrent bacterial infections
  • Decreased B cells and immunoglobulins
  • Treatment with IVIG
• DiGeorge Syndrome
  • T-cell deficiency, viral/fungal infections
  • Hypocalcemia, cardiac anomalies (truncus arteriosus)
• Other Syndromes
  • SCID, CGD, Ataxia Telangiectasia, Wiskott-Aldrich

Pediatric Tumors

• Wilms Tumor
  • Unilateral renal mass, hypertension
  • WT1 mutation, chromosome 11
• Neuroblastoma
  • Crosses midline, calcified, catecholamine production

Growth and Development

• Fetal Alcohol Syndrome
  • Microcephaly, smooth philtrum, ADHD
• Down Syndrome Associations
  • Hirschsprung's disease, duodenal atresia, cardiac defects

Common Pediatric Conditions

• Kawasaki Disease
  • Conjunctivitis, rash, cervical lymphadenopathy
  • Treat with IVIG and aspirin
• Henoch-Schönlein Purpura (HSP)
  • Palpable purpura, abdominal pain, intussusception risk

Infectious Diseases

• Lyme Disease
  • Amoxicillin for children under 8
• RSV and Croup
  • RSV: wheeze and supportive care
  • Croup: barking cough, treat with racemic epinephrine

Immunizations and Reactions

• Vaccines
  • Avoid live vaccines in immunocompromised and infants <1 year
  • Pneumococcal, meningococcal, and H. influenza for asplenic patients

Hematologic and Renal Disorders

• Osteomyelitis
  • Varies by age and condition (e.g., Staph aureus, Salmonella in sickle cell)
• Nephrotic and Nephritic Syndromes
  • Minimal change disease, post-streptococcal glomerulonephritis

Gastrointestinal and Endocrine Disorders

• Pyloric Stenosis
  • Non-bilious vomiting, hypochloremic metabolic alkalosis
• Cystic Fibrosis
  • Respiratory infections (Staph aureus <20 years, Pseudomonas >20 years)
  • Pancreatic insufficiency, sweat chloride test

Neurological and Skeletal Disorders

• Infantile Spasms and Tuberous Sclerosis
  • Treat spasms with ACTH or vigabatrin
• Osgood-Schlatter Disease
  • Pain over tibial tubercle, common in active children

Congenital Heart Defects

• Tetralogy of Fallot
  • Pulmonary stenosis, VSD, overriding aorta, right ventricular hypertrophy
• Transposition of the Great Arteries
  • Cyanosis, egg on a string appearance on X-ray

Genetic and Metabolic Disorders

• Glycogen Storage Diseases
  • Von Gierke's, Pompe, McArdle's
• Other Genetic Disorders
  • Turner syndrome, Klinefelter syndrome, Fragile X

Conclusion

• Comprehensive overview, covering a range of pediatric topics
• Emphasis on high-yield concepts for exam preparation

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This summary captures the key topics discussed in the lecture, providing a structured overview that can be used for review before the Pediatric Shelf Exam.