How Are Iliac Fractures Treated?
Discussion
Avulsion fractures of the pelvis are more commonly seen in adults and teenage athletes. Currently they are more common in male athletes but with the increased number of females in sports, more are also being seen in females. Soccer and track and field are common sports where these injuries occur. The injuries are felt to be caused by a repetitive traction on the apophysis or more commonly due to a ‘sudden, forceful, or unbalanced contraction of an attached musculotendinous unit while engaged in a sporting event…. Skeletal maturity has a direct effect on the incidence of the injury.” They can oc...
Source: PediatricEducation.org - April 19, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Toxin-Mediated Diseases?
Discussion
A poison is a generic term for “a substance with an inherent property that tends to destroy life or impair health.” A toxin is more specific and is “any poison produced by an organism, characterized by antigenicity in certain animals and high molecular weight, and including the bacterial toxins that are the causative agents of tetanus, diphtheria, etc., and such plant and animal toxins as ricin and snake venom.” A toxin does not include those substances that are made synthetically produced. Venom is also a toxin that is used by animals and insects for predation or defense which can cause ...
Source: PediatricEducation.org - April 12, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Recommendations for Using Portable Listening Devices?
In this study listening to audiobooks, movies, or playing videogames was less likely to exceed the threshold. However the use of PLDs has increased overtime, particularly with the need for online educational activities due the COVID-19 pandemic. Use of PLDs particularly in the setting of other ambient noise and the duration of the activities may have changed since this and other studies were published.
Problems associated with increased noise aren’t just hearing loss but other aural problems including tinnitus, sound distortion, difficulty understanding speech, dizziness, and earache. Other “extra-auditive da...
Source: PediatricEducation.org - April 5, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Indications for a Ileostomy?
Discussion
There are three types of inflammatory bowel disease (IBD):
Crohn’s disease (CD) – can affect entire gastrointestinal tract but often is discontinuous (i.e., has skipped areas), has transmural inflammation and disease, has granulomas
Ulcerative colitis (UC) – affects the colon, is continuous (i.e., has no skipped areas) and has superficial mucosal ulcerations
Unclassified IBD – has chronic colitis but not specific features of CD or UC
The specific pathogenesis appears to be multifactorial with having a genetic predisposition (1.6 – 30% risk of developing UC if patient has first deg...
Source: PediatricEducation.org - March 29, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Enjoying the Spring
PediatricEducation.org is taking a short Spring break. The next case will be published in on March 29. In the meantime, please take a look at the different Differential Diagnoses, Symptom and Disease listed at the top of the page. Maybe enjoy some cool spring air outside as well.
We appreciate your patronage,
Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - March 22, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Generalized Anxiety Disorder Treatment Components?
Discussion
Generalized anxiety disorder (GAD) is “…excessive anxiety and worry about a number of events and activities coupled with at least one physical symptom, which may include fatigue, poor concentration, restlessness, irritability, muscle tension, and sleep difficulties.” Other ways it presents to the primary care office may be abdominal pain, headache or heart palpitations, dizziness, syncope, numbness, trembling, paresthesia, memory loss, or urinary frequency. It has an estimated prevalence of 15% and is the second most common anxiety disorder in children after social anxiety disorder. GAD can com...
Source: PediatricEducation.org - March 15, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are the Causes of Secondary Amenorrhea?
Discussion
The first sign of puberty in females is breast budding (Tanner stage II) which normally occurs from 8-13 years. Menarche usually occurs within 2 years of breast budding occurring usually at Tanner stage III-IV breast development. Menarche occurs for most girls from 10-15 years. Most cycles range between 21-45 days.
Age > 13 years without acquisition of secondary sexual characteristics, > 15 years before menarche or 5 years after acquisition of secondary sexual characteristics or cycles longer than 45 days are indications for evaluation. After menarche is it not uncommon to have anovulatory cycles that are ...
Source: PediatricEducation.org - March 8, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Who Gets Pott ’ s Puffy Tumor?
Discussion
Pott’s puffy tumor (PPT) was first described by Sir Percivall Pott in 1775 and who also described other orthopaedic and oncological diseases subsequently named for him. “It is a subperiosteal abscess of the anterior wall of the frontal sinus associated with underlying frontal osteomyelitis.” The tender edema and swelling of the forehead is the sign of PPT. Associated fever, headache, and rhinorrhea along with similar problems such as postnasal drip or nasal congestion are common. Associated ophthalmological problems include peri-orbital or eyelid edema and/or preseptal cellulitis. Ptosis and di...
Source: PediatricEducation.org - March 1, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Common are Aortic Aneurysms?
Discussion
Aortic root dilatation or thoracic aortic aneurysm occurs in 6:100,000 individuals > 50 years of age. It is due to aging, hypertension, hypercholesterolemia, and smoking. Tertiary syphilis was a cause in the preantibiotic era.
Pediatric aneurysms are very uncommon but the exact prevalence is different due to the various causes. Aneurysms are due to genetic disorders, congenital anomalies or post-surgical repair. In pediatric patients with sudden cardiac deaths, 5.4% are due to ruptured thoracic aortic aneurysms.
Learning Point
Some causes of pediatric aneurysms include:
Familial thoracic aneurysm and dissect...
Source: PediatricEducation.org - February 22, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
When Should Cutis Aplasia be Worked Up?
Discussion
Aplasia cutis congenita (aka cutis aplasia, CA) is an uncommon dermal defect that is usually noted at birth or soon after birth. A variable amount of dermal tissue is absent. It is usually an isolated defect. The actual causes are unknown but genetics, developmental and destructive forces are logically the cause. Developmental forces do not allow the appropriate formation and closure of the skin (example would be a syndrome) and destructive forces (such as amniotic bands) harm the tissue so that it is disrupted. On physical examination CA may look like a small hypertrophic or atrophic scar. It can also be covere...
Source: PediatricEducation.org - February 15, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What is a Lipschultz Ulcer?
Discussion
Acute genital ulcers (AGU) are much less common in sexually-naive women than sexually experienced or active women. The differential diagnosis of AGU is large. For sexually active women Herpes simplex virus is the most common cause. Sexually transmitted infections are also included in this differential. In addition to the pain, AGUs can cause distress for the patient and family as possible sexual abuse must be considered.
The differential diagnosis of AGU in non-sexually active women includes:
Aphthosis
Lipschutz ulcer
Idiopathic
Autoimmune or inflammatory diseases
Behcet disease
Bullous pemphigoid
Inflammato...
Source: PediatricEducation.org - February 8, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Potential Complications of Hearing Aids?
Discussion
Hearing loss can range from profound deafness to fairly minor loss. The causes vary based on age, type of loss (sensorineuronal or conductive, about half of hearing loss in children has a genetic cause), degree and audiometric configuration. Sensorineuronal hearing loss involves the cochlea and neural connections to the brain and auditory cortex. Conductive hearing loss involves structures from the external ear to the oval window. Deafness is defined as a hearing loss > 90 dB. Hearing loss can affect the living and learning of children more than many people realize. “A child with a mild hearing loss can...
Source: PediatricEducation.org - February 1, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Lethargy?
Discussion
Lethargy is a common word used to describe a person who is drowsy, sluggish, listless and apathetic. Concentration may be difficult and they may have problems doing simple tasks. Many people actual mean fatigue or lassitude or being more tired when they use the word. In medical terms, lethargy is usually used to describe patients who have some type of excessive tiredness and usually have mental status changes with decreased alertness or arousal. Patients and health care providers both usually qualify the term and give more description to better communicate what is implied when using the term. This is true of man...
Source: PediatricEducation.org - January 25, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Potential Problems of Congenital Lung Malformations?
Discussion
Congenital lung malformations (CLM) are commonly identified with prenatal ultrasound and occur in ~1:2400 live births. The natural history shows that lesions may remain the same, enlarge or appear to disappear. There is a wide-range of clinical manifestations. Patients may be asymptomatic or symptomatic at birth and often develop symptoms later.
The overall natural history is difficult to ascertain as there are fewer studies done in older children and adults. Those that are done often lack a good denominator by which to judge the incidence or prevalence. Resection is carried out usually if a patient is symptomat...
Source: PediatricEducation.org - January 18, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Long Do You Monitor Neonates for Neonatal Abstinence Syndrome (NAS)?
Discussion
Neonatal abstinence syndrome (NAS) occurs in the first few days of life and is a complex withdrawal syndrome. The newborn is abruptly cut-off from their exposure to licit or illicit drugs that the mother is chronically consuming and which were being transmitted through the placenta to the fetus. “NAS is a highly variable and severe condition; it may be associated with central and autonomic nervous system dysfunction … and gastrointestinal disorders.” It can cause significant morbidity but is rarely fatal.
Fetal exposure has been increasing in the United States. In 2011-12, almost 5.9% of pregna...
Source: PediatricEducation.org - January 11, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
