When Does Executive Function Happen?
Discussion
Executive function (EF) is the “…cognitive processes that facilitate goal-directed action and problem solving, such as working memory, cognitive flexibility, inhibitory control, and self-monitoring. EF skills are important for the conscious, effortful control of thoughts and behaviors.”
EF allow us to inhibit ingrained behaviors that could get us into trouble, e.g. shouting out in a classroom, driving the wrong-way down a one-way street. EF also allow us to pay attention to what is meaningful for the time and situation e.g. academic testing, paying attention to traffic and not the radio while ...
Source: PediatricEducation.org - February 10, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Do You Do For Breast Milk Jaundice?
Discussion
Almost all infants in the first few days of life have some elevation of their bilirubin because of the various physiologic changes they undergo in the transition to extra-uterine life. This is a common problem managed by many different inpatient and outpatient healthcare providers. This hyperbilirubinemia is usually unconjugated and resolves in the first 1-2 weeks of life. However, when it does not resolve, health care providers have 3 general paths to follow when considering a cause: inadequate breast milk intake, an underlying organic cause or breast milk jaundice.
Inadequate breastfeeding is not uncommon and...
Source: PediatricEducation.org - February 3, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Should We Worry About Bicuspid Aortic Valve?
Discussion
The aortic valve usually has 3 leaflets. In bicuspid aortic valve (BAV) there are 2 asymmetric leaflets with a fish-mouthed orifice between them which may not open fully. It occurs in about 0.5-2% of the population making it one of the most common congenital heart anomalies and the most common one in adults. Transmission is autosomal dominant yet males are more likely to have BAV, indicating potential reduced penetrance in females. “BAVs are different, however, in that the tissue pathology is not limited to the valves’ leaflets but extends from the left ventricular outflow tract to the ascending thor...
Source: PediatricEducation.org - January 27, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Who Self-Harms?
Discussion
IF YOU ARE IN A CRISIS SITUATION AND NEED HELP, call 1(800) 273-TALK(8255) there IS someone there who can help you, En Espanol 1-888-628-9454, or Text “HOME” to 741-741. Other resources are available at http://www.suicidepreventionlifeline.org
Non-suicidal self-injury (NSSI) is defined as the intentional, self-inflicted damage to the surface of the body without suicidal intention, which is not socially sanctioned[,]” such as piercing or tattooing. Examples of NSSI include self-cutting (70-97%), hitting (21-44%), burning (15-35%), scratching, banging, scraping or carving.
The prevalence is in...
Source: PediatricEducation.org - January 20, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Is the Classic Clinical Presentation of Pericarditis?
Discussion
The pericardium is a bi-layered membrane that envelops the heart and provides a barrier to prevent disease and also decreases friction as the heart moves. Pericarditis is the inflammation of pericardium. The incidence is underreported as asymptomatic or mild disease may go unrecognized. From hospitalized patient data, 0.2-5% of patients with various cardiac disease had pericarditis. An incidence rate for hospitalizations of 3.32 per 100,000 person years has been cited. Percarditis occurs more often in adolescent males.
Treatment of the underlying cause or suspected cause is important, along with close monitorin...
Source: PediatricEducation.org - January 13, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What are Indications for Wisdom Teeth Removal?
Discussion
Third molars (M3) are often referred to as wisdom teeth. They begin calcification at 7-9 years and usually erupt between 17-26 years. They usually erupt behind the second molar into what may be limited space. M3 can also fail to erupt. Impacted M3 occur because of abnormal position, obstruction, or lack of space.
There are 4 potential groups to consider for M3 management:
Group 1 – symptomatic with clinical disease
Epidemiology: common
Clinical presentations: edema, pain, trismus
Disease: caries, pericoronitis and infection are common
Treatment: treatment of disease is important but extraction is recom...
Source: PediatricEducation.org - January 6, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Holiday Break
PediatricEducation.org is taking an end of the year break. short break. The next case will be published on January 6,2020. If you are inclined you can review “Why Is it Called Christmas Disease?”
or take a look at the new Curriculum Map for pediatric residents new Curriculum Map for pediatric residents based on the American Board of Pediatrics content outline.
We appreciate your patronage,
Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - December 23, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Some Potential Adverse Effects of Blood Donation?
Discussion
Just under 40% of people are eligible to be a blood donor. Up to 6.5% of a population are actual donors. “Blood donors are healthy volunteers who give either whole blood or blood components by apheresis including platelets, plasma, red blood cells, peripheral blood stem cells and leucocytes or a combination of blood components. They represent a large, healthy population exposing themselves voluntarily for altruistic, sometimes financial motives to potential complications and risks.” Blood banking systems world-wide are responsible for caring for individual donors health as well as maintaining a robus...
Source: PediatricEducation.org - December 16, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Does Gaucher Disease Present?
Discussion
Gaucher disease (GD) was first described by Philippe Gaucher in 1882. It was the first lysosomal storage disease (LSD) described and is the comparison prototype for many variations and their treatment. There are about 50 LSD and more well-known ones include Fabry, Niemann-Pick and Pompe diseases. LSDs currently have more than 300 different enzymes or membrane proteins affected which cause central nervous system and visceral disease. Overall the frequency of LSDs in aggregate is 1:3000 – 7000 live births. GD has an estimated prevalence of 1:57,000 – 111,000. It is higher within the Ashkenazi Jewish po...
Source: PediatricEducation.org - December 9, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Respiratory Failure?
Discussion The respiratory system is a complex system. The upper airways must remain patient. The lower airways must interface with the vascular system. The musculoskeletal system must provide mechanical function and the central nervous system must provide overall control. Respiratory failure occurs when the overall system cannot support the body’s necessarily ventilation, oxygenation or both. Children are at higher risk of respiratory failure. They have few intrinsic lung parenchyma problems, but have very small airways that increase the airflow resistance by themselves but then have to contend with problems such as...
Source: PediatricEducation.org - December 2, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Is Hidradenitis Suppurativa Treated?
Discussion
Hidradenitis suppurativa (HS) is a recurrent, chronic inflammatory disease of the hair follicles particularly in the apocrine gland-bearing areas of the axilla, inguinal, perianal, mammary and inframammary areas. Onset is usually after puberty, in the early 20s. It is more common in females than males. Prevalence is estimated to be 0.05- 4.1%. It can be associated with premature adrenarche, metabolic syndrome and obesity.
The lesions are often pruritic, painful, and with malodorous purulent drainage. It often begins with comedomes and tender nodules, and can easily progress to painful abscesses with purulent f...
Source: PediatricEducation.org - November 25, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What is the Lifespan for a Child with Holoprosencephaly?
Discussion
Holoprosencephaly (HPE) is a clefting problem of the brain. “[HPE] the result of incomplete or absent midline division of the embryonic forebrain into distinct cerebral hemispheres (prosencephalon) between the 18th and 28th day after conception.”
There are four distinct subtypes:
Alobar – both hemispheres are completely fused and are not separated into the left and right hemispheres. There is agenesis of the corpus callosum, arrhinencephaly and a single ventricle with fused thalami. Facial features are almost always affected.
Semilobar – the cerebral hemispheres are fused anteriorly bu...
Source: PediatricEducation.org - November 18, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What is the Long-term Outcome of ACL Repair?
Discussion
The anterior cruciate ligament (ACL) “is an intra-articular but extrasynovial collagenous structure with limited healing capacity that originates in the posteromedial aspect of the lateral femoral condyle and crosses into anteromedially to insert anterior into the intercondylar eminence of tibial articular surface.” It plays an important part as a mechanoreceptor particularly as a proprioceptor. Its main role is to prevent excessive anterior tibial translation, limits varus/valgus stress when the knee is in full extension and some rotary movements of the knee.
There are ~120,000 surgeries per year m...
Source: PediatricEducation.org - November 11, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Does Non-Verbal Mean?
Discussion
Children can be non-verbal for many reasons with most just not wanting to talk in a given situation for a short period of time (e.g. angry with a person, scared to give a speech at school, etc.). Children may have the ability to communicate verbally but for some reason it is physically impaired for a period of time.
Selective mutism (SM) “… is characterized by an individual’s consistent failure to speak in social situations in which there is an expectation to speak (e.g., at school), despite speaking in other situations.” The lack of speech cannot be due to discomfort speaking in a given...
Source: PediatricEducation.org - November 4, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Indications for Dermatological Light Treatment?
Discussion
Spider telangiectasia or spider angiomas have a central red lesion with radiating dilatation of the distal, end vasculature that resemble arachnid appendages. They are common lesions (up to 38% in one study of children, and 60% in pregnant women), often solitary or < 3 lesions, and usually benign. Multiple lesions are characteristic of chronic liver disease. They can disappear over time (especially pregnancy related ones) but may not. The cause of these vascular lesions is unknown. Treatment is often not necessary, but laser treatments, fine needle electrocautery or electrodissection can be used.
Learning Poi...
Source: PediatricEducation.org - October 28, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
