What Causes Pulmonary Edema?
Discussion
Pulmonary edema is a potentially life threatening condition due to accumulation of excess fluid in the alveolar spaces and walls of the lung.
Patients show increased respiratory effort or distress (e.g. tachypnea, dyspnea or difficulty talking, use of excessory muscles, nasal flaring, tracheal tugging, etc.) and clinicians should beware signs of tiring (e.g. bradypnea and decreased effort) as the patient may be failing. Patients may have rales or rhonchi on pulmonary examination, and pallor or color changes may be noted. Blood gas analysis shows evidence of hypoxemia and often hypercapnia depending on the severi...
Source: PediatricEducation.org - May 15, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are the Symptoms of Serotonin Syndrome?
Discussion
Serotonin syndrome (SS) is a clinical diagnosis and problem which can be seen in patients of all ages. Classically SS presents with changing mental status, autonomic dysfunction and neuromuscular excitability. It is caused by increased serotonin levels because of therapeutically increasing the dose of a medication already being taken, adding an additional serotoninergic medication or one that potentiates serotonin, overlapping transition when changing medications, or intentional or unintentional overdose. It has become more common especially as selective serotonin reuptake inhibitors (SSRIs) have been used more ...
Source: PediatricEducation.org - May 8, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are the Classifications of Perinatal Stroke?
Discussion
Perinatal stroke occurs in about 1:1000 live births and is a “focal vascular injury from the fetal period to 28 days postnatal age.” Perinatal stroke is the most common cause of hemiparetic cerebral palsy and causes other significant morbidity including cognitive deficits, learning disabilities, motor problems, sensory problems including visual and hearing disorders, epilepsy, and behavioral and psychological problems. Family members are also affected because of the potential anxiety and guilt feelings that having a child with a stroke presents, along with the care that may be needed over the child&#...
Source: PediatricEducation.org - May 1, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are the Goals of Hypospadias Repair?
Discussion
Hypospadias is one of the most common congenital malformations and is the most common penile malformation. It is defined as the urethral opening occurring on the ventral side of the penis. Other ventral tissues can be affected thus other problems such as penile curvature and/or scrotal problems can also occur. Embryologically the penis is formed in the following way:
“At the beginning of the ambisexual stage, the urethral groove [is] bounded by the urethral folds [and] extends about halfway distally along the ventral aspect of the elongating genital tubercle. At the distal aspect of the urethral groove is ...
Source: PediatricEducation.org - April 24, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How is Osgood-Schlatter Apophysitis Treated?
Discussion
An apopysis is a secondary ossification center located at the tendinous insertion into a bone. Site irritation is called apophysitis and several proposed causes include genetics, rapid growth, trauma (compression or traction), anatomical differences and diet. Whatever the etiological factors, it causes pain. Examples include Sever’s disease of the calcaneus.
Anterior knee pain is a common presenting problem in the pediatric age group, and the differential diagnosis is broad. Trauma, infection, tumors, and referred pain need to be considered but soft tissue problems tend to predominate if not a traumatic ca...
Source: PediatricEducation.org - April 17, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Parotitis?
Discussion
The salivary glands are important for creating saliva which helps with taste, digestion, oral health, and speech. Salivary gland problems are not that common but can be painful, annoying or herald potential systemic diseases. The parotid gland is the largest salivary gland lying anterior to the ear within the cheek structures. There are 2 lobes (superficial and deep) and the facial nerve runs between them. The salivary duct opens adjacent to the upper second molar. Infections are the most common cause of parotitis with mumps being the most commonly associated infection especially in unimmunized patients.
Patient...
Source: PediatricEducation.org - April 10, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Immunity Do Breast Milk Antibodies Confer?
Discussion
Breast milk (BM) has many benefits including its primary role providing appropriate nutrition for newborns and infants, which includes making those nutrients more bioavailable. While BM does not provide all of the nutritional needs over the entire year or two of breastfeeding, complimentary foods are important for furnishing additional nutritional needs along with helping development of appropriate taste and texture acceptance, along with oral-motor skills. Complimentary foods are recommended by the American Academy of Pediatrics when the infant is developmentally ready which is commonly after 6 months of life. ...
Source: PediatricEducation.org - April 3, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What are Presentations of Neuroblastoma?
Discussion
Abdominal pain is a very common problem with abdominal masses being somewhat less common. If one considers how frequently patients have abdominal pain due to constipation and that it often presents with a fecal mass, both of these are commonplace. Abdominal and pelvic organs are sometimes mistaken for masses also. As the abdominal and pelvic cavities are large, tumors often need to be quite large before they cause functional problems and/or can be palpated on physical examination.
A review of abdominal masses can be found here.
A review of recurrent abdominal pain can be found here.
A review of acute abdominal p...
Source: PediatricEducation.org - March 27, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Presentations of Neurocysticercosis?
Discussion
Neurocysticercosis (NCC) is the most common parasitic CNS infection world-wide. It is caused by the larval stage of the pork tapeworm Taenia solium. It is endemic in Southeast Asia including the Indian Subcontinent, sub-Saharan Africa and Latin America. It is becoming more common in other areas of the world because of immigration and the overall ease of travel.
The basic Taenia lifecycle is that humans eat un- or undercooked pork (pigs are the intermediate host) that is invested with the larvae called cysterici. The adult tapeworm forms in the human gastrointestinal tract and eggs are produced. Humans are the de...
Source: PediatricEducation.org - March 20, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Does Ebstein ’ s Anomaly Present?
Discussion
Ebstein’s anomaly (EA) accounts for about 0.3-0.5% of all congenital heart disease and about 40% of all tricuspid valve (TV) pathologies. It was first described by Dr. William Ebstein in 1866.
In EA’s simplest form, the TV is displaced inferiorly from the normal hinge points into the right ventricle (RV). This is caused by delamination of both the septal and mural leaflets and they usually form a combined leaflet which can be more adherent to the RV. These anatomical changes causes poor movement of the leaflet(s) and tricuspid regurgitation. Displacement inferiorly can cause decreased RV capacity and...
Source: PediatricEducation.org - March 13, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Winter Break
PediatricEducation.org is taking a short break. The next case will be published on March 13th. In the meantime, please take a look at the different Archives and Curriculum Maps listed at the top of the page.
We appreciate your patronage,
Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - March 6, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What is PAN?
Discussion
Vasculitis is an inflammation of the blood vessels. Often, the term implies the arterial vessels, but venous and capillary vessels can be affected. The nomenclature to describe vasculitis and its classification have varied over time. Arterial vessel size is one method and some more common entities include:
Small vessel, mainly
Granulomatous – granulomatosis with polyangiitis (aka Wegener’s granulomatosis), eosinophilic granulomatosis with polyangiitis (aka Churg Strauss syndrome)
Nongranulomatous – Henoch-Schonlein purpura (HSP), microscopic polyangiitis
Medium vessel, mainly
Childhood sys...
Source: PediatricEducation.org - February 27, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Mediastinal Masses?
Discussion
The mediastinum resides in the chest and is the space bounded by the thoracic inlet cephalically, diaphragm caudally, sternum anteriorly and transverse process of the spine posteriorly, and mediastinal pleura and lungs laterally. It is divided into various compartments:
Superior mediastinum
Bounded by the thoracic inlet cephalically and a horizontal plane passing from the manubriosternal joint to the junction of T4/T5 vertebrae horizontally.
Structures include: esophagus, trachea, parts of great vessels and first branches, great veins and initial branches, thymus, vagus, phrenic and other nerves, thoracic duct...
Source: PediatricEducation.org - February 20, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Meconium: It Can Cause a Sticky Mess
Discussion
During fetal life from approximately 12-13 weeks gestation, meconium accumulates in the small bowel and migrates to the large bowel and rectum by ~20 weeks gestation. Meconium is a combination of bile, mucous, desquamated intestinal cells, bowel secretions, dessicated swallowed amniotic fluid and lanugo. It is sterile before birth and once produced is odorless with a blackish green (sometimes brown or yellow) color, and tarry or sticky quality. Defecation does not occur during fetal life unless the fetus is significantly stressed. Normal meconium passage after birth occurs within 24-48 hours of life (more often ...
Source: PediatricEducation.org - February 13, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Laboratory Tests Are Consistent with Transient Erythroblastopenia of Childhood?
Discussion
Transient erythroblastopenia of childhood (TEC) is an “…anemia with a hemoglobin level at least 2 [standard deviations] below normal and a low reticulocyte count in relationship to the anemia in the absence of evidence of alternative causes of anemia.” A bone marrow aspirate shows decreased or absent erythroid precursor cells if obtained. The etiology is not well understood but may have a stimulating cause such as a viral infection, an immune-related and/or genetic cause. Parvovirus causing bone marrow suppression has been implicated and there are cases of affected siblings.
TEC is most common ...
Source: PediatricEducation.org - February 6, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
