Basic mnemonics in paediatrics - part two

Basic mnemonics in paediatrics - part two

26. Cerebral palsy: general features

Cerebral palsy (CP) is a group of disorders that affect a person's ability to move and maintain balance and posture. In many cases, vision, hearing, and sensation are also affected. CP is the most common motor disability in childhood.

 

General features are:

PALSY:

  • Paresis
  • Ataxia
  • Lagging motor development
  • Spasticity
  • Young

 

27. Cerebral palsy (CP): most likely cause

Please refer to number 26 for its description.

 

Causes of cerebral palsy are:

  • CP: Cerebral Palsy
  • Child Premature

 

28. Cerebral Palsy: Types

Please refer to number 26 for its description.

 

Types of cerebral palsy are:

SADAM:

  • Spastic (Increase tone)
  • Athetoid
  • Diskinetic (Involuntary & uncontrolled movements)
  • Ataxic (cerebellar  damage with fine motor skills & balance difficulty)
  • Mixed

 

29. Clinical Presentation of brain tumors: Sign & symptoms

Brain tumor is a malignant or non-malignant mass or growth of abnormal cells in the brain. Tumors can originate in the brain, or cancer elsewhere in the body can spread to the brain. Types include: Acoustic neuroma, Astrocytoma, Brain metastases, Choroid plexus carcinoma, craniopharyngioma,  Embryonal tumors, Ependymoma, Glioblastoma, Glioma,

Medulloblastoma, Meningioma and so on.

 

Signs and symptoms are:

BAHENNS:

  • Blurring of vision
  • Ataxia
  • Headache
  • Endocrine dysfunctions
  • Nystagmus
  • Nausea & vomitting
  • Squint

 

30. Dandy-Walker syndrome: components

Dandy-Walker Syndrome also known as Dandy-Walker Malformation is a congenital brain malformation involving the cerebellum and the fluid-filled spaces around it.

 

Components of Dandy-Walker Syndrome include:

"Dandy Walker Syndrome":

  • Dilated 4th ventricle
  • Water on the brain
  • Small vermis

 

31. Fetal alcohol syndrome (FAS): features

Fetal alcohol syndrome are group of conditions  in a child that results from alcohol exposure during the mother's pregnancy.

 

The following are the features of Fetal alcohol syndrome:

FAS:

  • Facial hypoplasia/ Forebrain malformation
  • Attention deficit disorder/ Altered joints
  • Short stature/ Septal defects/ Small I.Q

 

32. Sturge-Weber syndrome: hallmark features

Sturge-Weber syndrome (SWS) is a neurological disorder characterized by a distinctive port-wine stain on the forehead, scalp, or around the eye. This stain is a birthmark caused by too much capillaries near the surface of the skin.

 

Hallmark features are: 

Sturge-Weber:

  • Seizures
  • PortWine stain

 

33. Cyanotic congenital heart diseases: 5 types

Cyanotic heart disease refers to a group of different heart defects that are present at birth (congenital) which result in a low blood oxygen level.

 

Types are:

5 T's:

  • Truncus arteriosus
  • Transposition of the great arteries
  • Tricuspid atresia
  • Tetrology of Fallot
  • Total anomalous pulmonary venous return

Or

 

 Use your five fingers:

  • 1 finger up: Truncus Arteriosus (1 vessel)
  • 2 fingers up: Dextroposition of the Great Arteries (2 vessels transposed)
  • 3 fingers up: Tricuspid Atresia (3=Tri)
  • 4 fingers up: Tetralogy of Fallot (4=Tetra)
  • 5 fingers up: Total Anomalous Pulmonary Venous Return (5=5 words)

 

34. Tetrology of Fallot: components

Tetralogy of Fallot is a rare condition caused by a combination of four heart defects that are present at birth. It causes oxygen-poor blood to flow out of the heart and into the rest of the body. Risk factors include a viral illness such as rubella (German measles) during pregnancy, maternal alcoholism or a family history of the condition.

 

Components are:

"Don't DROP the baby":

  • Defect (VSD)
  • Right ventricular hypertrophy
  • Overriding aorta
  • Pulmonary stenosis

 

35. Vacterl syndrome: components

Vacterl stands for a group of conditions that affect many body system. These conditions tend to occur together.

 

Components are:

VACTERL:

  • Vertebral anomalies
  • Anorectal malformation
  • Cardiac anomaly
  • Tracheo-esophageal fistula
  • Exomphalos (aka omphalocele)
  • Renal anomalies
  • Limb anomalies

 

Read also: basic mnemonics in obstetrics and gynecology

 

36. Measles: complications

Measles is a highly contagious viral infection of the respiratory system that affect children. It can be prevented by vaccine.

 

Complications of measles are:

"MEASLES COMP" (complications):

  • Myocarditis
  • Encephalitis
  • Appendicitis
  • Subacute sclerosing panencephalitis
  • Laryngitis
  • Early death
  • Shits (diarrhea)
  • Corneal ulcer
  • Otis media
  • Mesenteric lymphadenitis
  • Pneumonia and related (bronchiolitis-bronchitis-croup)

 

37. Rashes: time of appearance after fever onset

Rashes are abnormal changes in skin color and/or texture which usually result from inflammation of the skin. Causes include rubella, small pox, chicken pox, measles an so on.

 

Time of appearance after fever onset for different causes are:

"Really Sick Children Must Take No Exercise":

 

Number of days after fever onset that a rash will appear:

  • 1 Day: Rubella
  • 2 Days: Scarlet fever/ Smallpox
  • 3 Days: Chickenpox
  • 4 Days: Measles (and see the Koplik spots one day prior to rash)
  • 5 Days: Typhus & rickettsia (this is variable)
  • 6 Days: Nothing
  • 7 Days: Enteric fever (salmonella)

 

38. Rubella: congenital signs

Rubella, also known as German measles, is an infection caused by the rubella virus. It is best known by its distinctive red rash.

 

Congenital signs are:

"Rubber Ducky, I'm so blue!" (like the "Rubber Ducky" song):

  • Rubber: Rubella
  • Ducky: Patent Ductus Arteriosus, VSD and pulmonary artery stenosis.
  • I'm: Eyes (cataracts, retinopathy, micropthalmia, glaucoma).
  • Blue: "Blueberry Muffin" rash (extramedullary hematopoesis in skin +purpura)

 

39. Septic Arthritis: most common cause

Septic arthritis, also known as joint infection or infectious arthritis, is the invasion of a joint by an infectious agent(most commonly Staphylococcus aureus) resulting in joint inflammation. Symptoms typically include redness, heat and pain in a single joint associated with a decreased ability to move the joint. 

 

Most common cause:

  • Staphylococcus Aureus is the most common cause of
  • Septic Arthritis in the pediatric population.

 

40. Ataxia-Telangiectasia (AT): common sign

Ataxia telangiectasia (A-T) also known as Louis–Bar syndrome, is an autosomal recessive, complex genetic neurodegenerative disorder primarily characterized by cerebellar degeneration, telangiectasia, immunodeficiency, cancer susceptibility and radiation sensitivity.

 

Common sign:

AT:

  • Absent
  • Thymus

 

41. Guthrie card: diseases identified with it

Guthrie cards are cards commonly used to collect blood spots from the pricked heel of newborns to screen for diseases such as:

 

"Guthrie Cards Can Help Predict Bad Metabolism":

  • Galactosaemia
  • Cystic fibrosis
  • Congenital adrenal hyperplasia
  • Hypothyroidism
  • Phenylketonuria
  • Biotidinase deficiency
  • Maple syrup urine disease

 

42. Haematuria: differential in children

Haematuria is the presence of blood or blood cells in urine. It may be microscopic or gross.

 

Differential in children are’

ABCDEFGHIJK:

  • Anatomy (cysts, etc)
  • Bladder (cystitis)
  • Cancer (Wilm's tumour)
  • Drug related (cyclophosphamide)
  • Exercise induced
  • Factitious (Munchausen by proxy)
  • Glomerulonephritis
  • Haematology (bleeding disorder, sickle cell)
  • Infection (UTI)
  • In Jury (trauma)
  • Kidney stones (hypercalciuria)

 

43. Perez reflex

Perez reflex consists of the normal response of an infant when held in a prone position and pressed with a finger along the spine from the sacrum to the neck. The response is described as crying, flexion of the limbs and head elevation and pelvis. It can also trigger urination and defecation.

 

Therefore eliciting the PE​​rEz reflex will make the baby PEE.

 

44. Apgar Score: Components

Method of judging the condition of a newborn baby in which the baby is given a maximum of two points on each of five criteria.

 

Components are:

APGAR

  • Appearance: Cyanosed or not
  • Pulse: Rate
  • Grimace: Response to stimulus
  • Activity: Movements of the baby (muscle tone)
  • Respiration: Rate

 

45. Bilirubin: phototherapy

Bilirubin is a yellow compound that occurs in the normal catabolic pathway that breaks down red blood cells.. 

  • BiLirUbin absorbs light maximally in the
  • BLUe range.

 

Read also: basic mnemonics in surgery

 

46. Neonatal Resuscitation: Steps

Neonatal resuscitation also known as newborn resuscitation is an emergency procedure focused on supporting the approximately 10% of newborn children who do not readily begin breathing, thereby putting them at risk of irreversible organ injury and death.

 

Steps involved include:

Do What Pediatricians Said Totally  Or Be Inviting Costly Malpractice case

  • Drying
  • Warming
  • Positioning
  • Suctioning
  • Tactile Stimulation
  • Oxygen
  • Bagging
  • Intubation (endotracheal)
  • Chest compressions
  • Medications

 

47. Cough (chronic): differential

 

When cough in nursery, rock the "CRADLE":

  • Cystic fibrosis
  • Rings, slings, and airway things (tracheal rings)/ Respiratory infections
  • Aspiration (swallowing dysfunction, TE fistula, gastroesphageal reflux)
  • Dyskinetic cilia
  • Lung, airway, and vascular malformations (tracheomalacia, vocal cord dysfunction)
  • Edema (heart failure)

 

48. Croup: symptoms

Croup is an upper airway infection that blocks breathing and has a distinctive barking cough.

 

Symptoms include:

3 S's:

  • Stridor
  • Subglottic swelling
  • Seal-bark cough

 

49. Cystic fibrosis: exacerbation of pulmonary infection

Cystic fibrosis is an inherited life-threatening disorder that damages the lungs and digestive system. It  affects the cells that produce mucus, sweat and digestive juices and causes these fluids to become thick and sticky. They then plug up tubes, ducts and passageways.

 

CF PANCREAS:

  • Cough (increase in intensity and frequent spells)
  • Fever (usually low grade, unless severe bronchopneumonia is present)
  • Pulmonary function deterioration
  • Appetite decrease
  • Nutrition, weight loss
  • CBC (leukocytosis with left shift)
  • Radiograph (increase overaeration, peribronchial thickening, mucus plugging)
  • Exam (rales or wheezing in previously clear areas, tachypnea, retractions)
  • Activity (decreased, impaired exercise intolerance, increased absenteeism)
  • Sputum (becomes darker, thicker, and more abundant, forming plugs)

 

50. Cystic fibrosis: presenting signs

Check 49 for brief description.

 

Presenting signs are:

CF PANCREAS:

  • Chronic cough and wheezing
  • Failure to thrive
  • Pancreatic insufficiency (symptoms of malabsorption like steatorrhea)
  • Alkalosis and hypotonic dehydration
  • Neonatal intestinal obstruction (meconium ileus)/ Nasal polyps
  • Clubbing of fingers/ Chest radiograph with characteristic changes
  • Rectal prolapse
  • Electrolyte elevation in sweat, salty skin
  • Absence or congenital atresia of vas deferens
  • Sputum with Staph or Pseudomonas (mucoid)

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