What are Potential Problems with Placental Abnormalities?
Discussion “The placenta is a unique organ that sits at the interface of, and facilitates nearly all interactions between, maternal and fetal physiology. It is the sole source of oxygen and nutrition for the fetus, and provides a protective barrier against external insults. The placenta is also a highly adaptable organ that is capable of showing a wide range of pathological changes in response to various maternal and fetal factors and stressors.” The placenta has 3 layers: the amnion (fetal side), the chorion, and decidua (maternal side). In addition to making observations about the maternal and fetal sides, co...
Source: PediatricEducation.org - June 27, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

“Summertime…And the living is easy.”
As the song goes we are taking a break and will publish our next PediatricEducation.org case on June 27. Instead, why don’t you try a Random Case from the Archives. Just click the button on the top left. We always appreciate your patronage, Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - June 20, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

At What Age Do Children Have Imaginary Friends?
Discussion Paracosms are imaginary worlds or societies and is a creative activity in middle childhood. Storytelling and narrative activities are believed to help people “…to promote insight into behavior, contribute to empathy, help us find meaning in life events, and extend our experience beyond personal circumstance.” These narrative activities are public or private and based in real or fictional experiences. They can be communicated verbally or acted out and can focus on the character or the plot of the narrative. There is not a great deal of research on paracosms and much is asking adults to remember ...
Source: PediatricEducation.org - June 13, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Why Does Norovirus Spread So Easily?
Discussion Norovirus is a Caliciviridae family member. They were first observed by electron microscopy during a 1968 outbreak in Norwalk Connecticut (hence the alternative name of Norwalk virus). There are 3 genogroups and many genotypes within each genogroup. “Noroviruses are the leading cause of acute gastroenteritis in people of all ages worldwide, and are estimated to cause 12-24% of community-based or clinic-based cases…, 11-17% of emergency room or hospital cases, and approximately 70,000-200,000 deaths annually.” Seventy percent of cases occur in the 6-23 month age range. They have caused pandemics...
Source: PediatricEducation.org - June 6, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Chilblains: An Old But Now More Common Problem
Discussion Chilblains is also known as perniosis is an “…inflammatory dermatosis that generally affects the dorsal feet or hands during the periods of damp and cold, but not freezing, conditions…” It produces acryl lesions. Chilblains may be derived from the Old English words “chill” and “blegen” (sore). Pernio is thought be derivative of pern(a) or haunch of the leg as the feet and legs are commonly affected. Chilblain is usually idiopathic but has been associated with Raynaud disease, blood problems including cryofibrinogenemia and rheumatologic conditions such as systemic ...
Source: PediatricEducation.org - May 30, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Are These Stools Acholic?
Discussion Color can be difficult to discern and communicate. Stooling is an important part of overall health and an important harbinger of potential illness. Stooling consistency and color changes with food, environment, medication, and health conditions. For neonates and young infants, some hepatobiliary problems may not be seen at birth but in the next few days to weeks. This includes Alagille syndrome, biliary atresia and cystic fibrosis. It is not uncommon for these patients to have prolonged jaundice and therefore the diagnosis may be delayed with some presenting with increased jaundice, acholic stool and poor feedin...
Source: PediatricEducation.org - May 23, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is in the Differential Diagnosis for Brown and Grey Skin Conditions?
Discussion This is the fourth in a short case series of differential diagnoses of colored skin conditions. An introduction to dermatological terminologies and information about colors can be found here. A differential diagnosis by distribution and common pattern can be found here. For red, orange and yellow conditions, a review can be found here. For green, blue and purple conditions, a review can be found here. For black and white conditions, a review can be found here. Note that any color can be a normal variant for an individual or is physiologic for a given state. Acanthosis nigricans causes dark brown-black patches or...
Source: PediatricEducation.org - May 16, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is in the Differential Diagnosis for Black and White Skin Conditions?
Discussion This is the third in a short case series of differential diagnoses of colored skin conditions. An introduction to dermatological terminologies and information about colors can be can be found here. A differential diagnosis by distribution and common pattern can be found here. For red, orange and yellow conditions, a review can be found here. For green, blue and purple conditions, a review can be found here. For brown and grey conditions, a review can be found here. Note that any color can be a normal variant for an individual or is physiologic for a given state. When lesions of the opposite color of the normal s...
Source: PediatricEducation.org - May 9, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is in the Differential Diagnosis for Green, Blue or Violet Skin Conditions?
Discussion Acrocyanosis is commonly seen in the newborn period as the baby transitions to extra-uterine life. It appears as blue-purple coloration of the distal extremities which usually improves over several hours. Blue melanocytosis is also a common normal variant of skin color. It usually is seen on the posterior surface of the body around the spine and buttocks, but can also be on the upper parts of the extremities. It is a blue-black coloration that shows a normal skin undertone when palpated. This is the second in a short case series of differential diagnoses of colored skin conditions. An introduction to dermatologi...
Source: PediatricEducation.org - May 2, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is in the Differential Diagnosis for Red, Orange or Yellow Skin Conditions?
Discussion This is the first in a short case series of differential diagnoses of colored skin conditions. A differential diagnosis by distribution and common pattern can be found here. For green, blue and violet conditions, a review can be found here. For black and white conditions, a review can be found here. For brown and grey conditions, a review can be found here. Note that any color can be a normal variant for an individual or is physiologic for a given state. The skin is the largest organ of the body. It can be easily examined but for many clinicians continues to be difficult to describe what they are seeing. Analo...
Source: PediatricEducation.org - April 25, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is Vocal Cord Dysfunction?
Discussion Vocal cord function involves balancing muscular and neuronal functions. The superior laryngeal nerves (SLN) and recurrent laryngeal nerves (RLN) are the main nerves responsible for sensation and motor innervation. There are two sides to the larynx and they operate ipsilaterally, therefore one side can be affected while the other is not. Vocal cord paresis or paralysis are “an impairment of the vocal fold motor function that is caused by nerve or neuromuscular abnormalit[ies].” Paresis involves some maintenance of vocal cord movement while paralysis does not. Paresis is also more of a continuum than a...
Source: PediatricEducation.org - April 18, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Genetics of Multiple Endocrine Neoplasia (MEN)?
Discussion Primary care physicians often work as part of a health care team. Their job can be particularly important for helping oversee intermittent or ongoing surveillance for various diseases. Some of the challenges are changes in clinical guidelines or treatment for uncommon diseases, timelines for evaluation that are in the future (particularly several years), and communication between various health care providers especially across locations or health systems. It is not surprising that families with children with special health care needs may move closer to their providers and consolidate their care within one health...
Source: PediatricEducation.org - April 11, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Who ’ s Afraid of Needles?
Discussion There are products that are valued highly because of their design and function are elegantly suited for their use. Books would be one example and the hypodermic needle is another. Medical hypodermic needles are used for accessing bodily spaces (e.g. vascular, peritoneal, subarachnoid, dermal, etc.), obtaining specimens (both solid tissue and liquid) and to deliver drugs, biologicals, fluids and other treatments to patients. Medical procedures involving some type of needle are the most common procedures taught to health care providers. A brief history of syringes and hypodermic needles can be found here. A variet...
Source: PediatricEducation.org - April 4, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Corns, Calluses and Properly Fitting Children ’ s Shoes
Discussion Probably the most common foot problem is foot pain or skin problems. This can be due to chronic and acute trauma, mobility issues, normal development, activities and footwear. Common foot problems include: Acute trauma is probably one of the most common reason patients and families seek care for is pain after acute trauma. Children prior to full puberty with acute trauma may have a growth plate fractures or Salter-Harris fractures which can be reviewed here. Apophysitis and tendonitis are common overuse injuries where there is irritation of the tendon and its insertion points. Chronic overuse can also lead to f...
Source: PediatricEducation.org - March 28, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Potential Physical Examination Findings for Patients with Atrioventricular Canal Defects?
Discussion Atrioventricular canal defects (AVCD) are a heterogeneous range of congenital heart defects (CHD) arising from malformations of intracardiac septal development. Essentially the location where the 4 corners of the 2 atria and 2 ventricula meet is abnormally formed. There is partial or complete fusion of the mitral and tricuspid valves along with atrial (ASD) and ventricular septal defects (VSD). Fusion of the endocardial cushions occurs around 4-5 weeks gestation. The anatomy for an individual is bespoke as the variations of the valve leaflets, chordal attachments and variations in ASD and VSD are numerous. This ...
Source: PediatricEducation.org - March 21, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news