Fall Break
PediatricEducation.org is taking a fall break. The next case will be published in on October 10th.
In the meantime, why don’t you look at a Random Case from the top of the page? You can also look at the different Differential Diagnoses, Symptom and Disease lists too.
We appreciate your patronage,
Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - October 3, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Treatments for Panic Disorder?
Discussion
Panic disorder is “…one of the anxiety disorders and is characterized by repeated, unexpected panic attacks, involving physical symptoms such as racing heart, dizziness and chest pains, along with a fear of recurring attacks and changing behaviors to avoid further attacks.” It has both physical manifestations and mental ones including extreme fear such as mortal fear, loss of control and fear of alienation.
It is most common in teenagers aged 15-19 and is very common with about 1% of teens experiencing attacks. A study of college students in multiple countries found a lifetime prevalence of 5%....
Source: PediatricEducation.org - September 26, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
When is Bruxism Bad?
Discussion
Bruxism “is a masticatory muscle activity that may occur during sleep ([sleep bruxism, SB] characterized as rhythmic or non-rhythmic) and/or wakefulness ([awake bruxism, AB] characterized as repetitive or sustained tooth contact and/or by bracing or thrusting the mandible.)” Bruxism was first described in 1907. Bruxism studies are quite variable in their results given the lack of standardized diagnostic methods.
Patients or family members will often report tooth grinding noises, and on physical examination there will be abnormal tooth wear, tooth mobility, hypertrophy of the masseter muscles and othe...
Source: PediatricEducation.org - September 19, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Long Does A Cephalohematoma Take to Resolve?
Discussion
Cephalomatomas occur relatively commonly in 0.2-3% of newborn infants. They are blood collections in the subperiosteal skull bones, usually in the parietal area. They are usually unilateral but can be bilateral. They do not transilluminate. They are felt to be caused by pressure or other trauma and occur in vaginal and cesarean deliveries, with presumed periosteal disruption leading to externally located bleeding (not on the brain side of the bone). The blood fills the space with some pressure building up and the blood acts to tamponade itself. The blood coagulates, slowly organizes and is reabsorbed. If reabsor...
Source: PediatricEducation.org - September 12, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Sudden Vision Loss?
Discussion
Vision loss, whether chronic or acute, is distressing at any time for patients and families. Prompt evaluation and treatment are important as maintenance of any acuity and light or movement is considered paramount. Most vision loss is due to chronic problems and aging issues but the differential diagnosis is broad. For any age, but especially children, uncorrected refractive errors can cause problems in not only in childhood but throughout someone’s lifetime.
Visual impairment for distance vision is considered mild if worse than 6/12 in meters = 20/40 in feet or 0.3 LogMAR and for moderate impairment is 6/...
Source: PediatricEducation.org - September 5, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Common is Tongue-Tie?
Discussion
The anterior 2/3s of the tongue is formed from the 2 lateral lingual swellings fusing with the tuberculum impar and then separating from the mouth’s floor to form the lingual sulcus. Separation failure can result in anchoring of the tongue to varying degrees. Frenula are soft tissue structures which attach and support other oral structures. The lingual frenula attaches the tongue to base of mouth. Labial frenula are located centrally and attach the lips to the alveolar ridges. Often less prominent are the buccal frenula which are on the labial side and are smaller and more lateral to the labial frenula, us...
Source: PediatricEducation.org - August 29, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Caused This Summer Birthday Party Rash?
Discussion
Panniculitides are a diverse group of problems involving inflammation of subcutaneous fat. Subcutaneous fat has limited ability to show different patterns of disease and therefore the clinical appearance is the same but has different etiologies. The skin appears red or purple, swollen, may have discrete nodule(s) or plaque(s) and the affected area can be painful or pruritic. If necessary skin biopsy can help determine the etiology. Overall panniculitides are not very common but some presentations are expected because of particular exposure (i.e. cold) or inflammatory disease processes.
Types of panniculitides in...
Source: PediatricEducation.org - August 22, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What is Ondine ’ s Curse?
Discussion
Congenital central hypoventilation syndrome (CCHS) is an autosomal dominant with variable inheritance genetic disease caused by mutation in the Paired Like Homeobox B2 (PHOX2B) gene on chromosome 4. There are two other genes which may also cause CCHS. CCHS affects the chemoreceptor afferent ventilation pathways and is a neural crest migration problem of the autonomic nervous system. The incidence is unknown but a prevalence of 1 in 200,000 live births has been reported. Obviously it is a rarer phenomenon because of the general lethality of the syndrome.
Patients usually present at birth or soon afterwards, but o...
Source: PediatricEducation.org - August 15, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Kyphosis?
Discussion
There are 3 planes to view and describe spinal deformities from:
Coronal or frontal plane – the view is from front or back of the patient
Sagittal plane – is the view from the side of the patient
Transverse or horizontal plane – is the view from the top or bottom of the patient
Normally the spine is straight when viewed from the frontal or coronal plane. Normally the spine also has a small kyphosis in the thoracic region (20-45%) and lordosis in the sacral region when viewed laterally in the sagittal plane.
Scoliosis or abnormal deviation of the spinal laterally is the most common spinal defo...
Source: PediatricEducation.org - August 8, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Causes of Childhood Interstital Lung Disease?
Discussion
Interstitial lung disease in children (chILD) is less understood than adult interstitial lung disease (ILD) and is rare. Prevalence is ~ 0.13 to 16.2 per 100,000 children under age 17 years. chILD is an general term for respiratory disorders that are heterogeneous, chronic and impair lung function. While some define diffuse parenchymal lung disease (DPLD) separately, the term ILD usually encompases DPLD. chILD has variable definitions and is “usually diagnosed if three of the following features are present:
1) respiratory symptoms (cough, rapid and/or difficult breathing, and exercise intolerance),
2) res...
Source: PediatricEducation.org - August 1, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What is the Buffalo Treadmill Test?
Discussion
Head injury and concussion diagnosis and treatment continues to evolve. The current recommendations are evolving from more strict rest and wait to more limited activity and exercise. Interventions have shown data supporting reasonable exercise as not more harmful and potentially beneficial.
Learning Point
The Buffalo Concussion Treadmill Test (BCTT) evaluated 13-18 year old athletes (N=103) using a randomized controlled trial of early subthreshold aerobic exercise for sports-related concussion. The control group performed a stretching program for the same amount of time and were given the same general care instr...
Source: PediatricEducation.org - July 25, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Are Port-Wine Stains Treated?
Discussion
Port-wine stains (PWS) or birthmarks are capillary and post-capillary venule malformations which are usually congenital but can be acquired. In newborns they occur in 0.3-0.5% of births. They are pink to dark-red to purple in color, usually flat and solid across the tissue. They are persistent lesions and can develop to have hypertrophy and nodular characteristics. They can occur in any location but tend to involve the head and neck. Isolated PWS are associated with GNAQ, GNA11 and PiK3CA hot spot genetic mutations. PWS are also associated with some syndromes such as Sturge-Weber, Klippel-Trenaunay, other phakom...
Source: PediatricEducation.org - July 18, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What is Prolonged Grief Disorder?
Discussion
Grief is the process of experiencing different emotions, expressions and action in response to the death of someone the person cares about. This is a personal and private process. Grief can occur for other significant losses such as a divorce, job, or health. People may overlook loss of routine and special activities, presumed safety, and autonomy that can also cause loss and grief. Additional traumas of these loss types have been magnified especially in the past couple of years as the world lives with Covid. Mourning is a public process of showing grief. This often involves religious beliefs and customs, and cu...
Source: PediatricEducation.org - July 11, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How to Remove Foreign Bodies?
Discussion
Living in the world makes the human body susceptible to foreign bodies. Orifices are particularly inviting for children to explore and see how it feels if the opening is touched by their hands or an object. Small objects are easily inserted or even just retained (such as toilet tissue in the genital area, or tissue in the nose). The mouth is particularly inviting to explore objects with as oral sensations are paramount to survival even at birth. Food can be considered a foreign body and often acts like one when stuck in the respiratory or gastrointestinal tract but is necessary to sustain life.
When someone says...
Source: PediatricEducation.org - July 4, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
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