Pediatric pathology

Paediatrics: Gynaecomastia

This is a condition affecting boys in which there is hyperplasia of the glandular tissue of the breast resulting in enlargement of one or both breasts.

Paediatrics: Precocious puberty - management

The diagnosis is based on demonstrating progressive pubertal development and increased growth rate, together with laboratory evidence of increased sex steroid production.

Paediatrics: Delayed puberty - management

Children with CDGP may be treated with a short course of sex steroid therapy to promote physical development and growth (see Constitutional delay of growth and puberty).

Paediatrics: Assessment of puberty

The puberty stage can be rated using the Tanner staging system.

Paediatrics: Hypercalcaemia

There are a number of different causes of high plasma calcium levels: · William’s syndrome. · Idiopathic infantile hypercalcaemia.

Paediatrics: Type 1 diabetes mellitus - associated illnesses

Patients with T1DM are at increased risk for a number of other autoimmune disorders.

Paediatrics: Hypertension: definition

Normal: systolic and diastolic <90th centile.

Paediatrics: Haematuria

Blood in the urine (haematuria) may be visible to the naked eye or it may be microscopic and detected only by dipstick testing or by microscopy.

Paediatrics: Intestinal parasites

Infection is usually via the faecal-oral route. Pets and livestock can be hosts.

Paediatrics: Jaundice

Jaundice occurs when serum bilirubin >25–30mmol/L. It is rare outside the neonatal period.

Paediatrics: Acute diarrhoea

Normal stool frequency and consistency vary, e.g. breastfed infants may pass 10–12 stools per day, primary school children may pass stool from three times a day to once every three days.

Paediatrics: Sleep apnoea

Apnoea is defined as a lack of breathing. Obstructive apnoea refers to a lack of airflow in the face of respiratory effort.

Paediatrics: Common presentation: stridor

Stridor is a noise heard during the inspiratory phase of breathing.

Paediatrics: Suprapubic aspiration of urine

The optimal method for obtaining urine for bacteriology in a child <2yr old.

Paediatrics: CNS malformations

Overall incidence 74–5/10 000 births. There has been a dramatic fall in the last 50yrs.

Paediatrics: Routine care of the new-born

Routine measurements · Measure within 1hr of birth: · Weight (term mean 73.5kg); · Head circumference (mean 735cm); · Body length (mean 750cm).

Paediatrics: Neonatal seizures

Incidence ~2–4/1000 live births. Usually occur 12–48hr after delivery.

Paediatrics: Birth trauma

LGA, cephalic–pelvic disproportion, malpresentation, precipitate delivery, instrumental delivery, shoulder dystocia, prematurity.

Paediatrics: Basic obstetrics

The aim of obstetrics is to monitor and promote foetal and maternal well-being during pregnancy and labour and to identify and manage high-risk pregnancies or complications.

Paediatrics: Poisoning

The peak incidence of childhood accidental poisoning is between the ages of 2 and 3yrs.

Paediatrics: Respiratory distress -Management

Respiratory drive: pattern and timing of breathing may reflect a central or brainstem cause.

Paediatrics: Vital signs

See Tables 3.1 and 3.2 for normal values of respiratory rate, heart rate (HR), and BP at different ages.

Paediatrics: Respiratory system

Lips and buccal mucosa: what is the colour of the mucous membranes and lips? Is the tongue in good condition? What is its colour? Are there any plaques, white patches, or spots?

Paediatrics: Cardiovascular system

Colour and cyanosis: examine the colour of the sclerae and conjunctivae.

Paediatrics: Gastrointestinal system

For hands, mouth, tongue, and eyes see respiratory and cardiovascular systems. Assess whether the child is jaundiced.