Pediatric Medical Facts in Brevity

Aqueduct stenosis is the most common congenital cause of obstructive hydrocephalus  Aqueduct of sylvius is the most common site of obstruction in acquired obstructive hydrocephalus  CT scan is the most important investigation in diagnosis of hydrocephalus  In shunt operation: ventriculoperitoneal shunt is the most common  Spastic cerebral palsy is the most common type of cerebral palsy (70% of cases)  Athetosis is the commonest abnormal movement associated with dyskinetic cerebral palsy  The most common cause of seizures is idiopathic (or cryptogenic) 80%  Simple febrile convulsions is the most common type of febrile convulsions (80%)  Enteroviruses are the most common viruses that cause meningitis  2/3 of cases of meningitis is viral meningitis  Herpes simplex type1 and type2 are the most common cause of encephalitis  Bilateral slowing of background is the most usual finding in encephalitis Epileptic spasms (formerly infantile spasms): infants only: 3-8 months  Febrile convulsions: between 9 months-5 years  Cyanotic and pallid breath holding spells: between 6-18 month  Remission of sleep myoclonus is spontaneous at 2-3 months  Meningitis: during the 1st 2 months of life -B β hemolytic streptococci -Gram negative enteric bacilli: E coli -Listeria monocytogenes  Meningitis: from 2 months to 12 years -Hemophilus influenza type B -Pneumococci -Meningococci  Manifestations of meningeal irritation: absent in infants less than 18 months  Brain abscess: Most common between 4-8 years  Acute disseminated encephalomyelitis: can occur at any age but most series report a mean age between 5-8 years  Duchenne muscular dystrophy: usually during the 1st 5 years or before  Duchenne muscular dystrophy: unable to walk by the age of 10 years  Duchenne muscular dystrophy: die between 15-25 years with respiratory infection  ADHD: symptoms have to develop before the age of 7 years and persist for 6 months at least in two or more settings (e.g., home and school)  Brain abscess most commonly affects frontal, parietal and temporal lobes  MRI brain is the most reliable investigation for brain abscess  Spinal muscle atrophy is the most common cause of floppy infant  Acute post infectious polyneuropathy: Guillain Barre syndrome is the most common cause of acute paralysis in children  IV gammaglobulin for 5 successive days is the best treatment for Guillain Barre syndrome  Poliomyelitis: 90-95% of cases ►unapparent infection  Duchenne muscular dystrophy is the most common and most serious muscular dystrophy  Clumsy child with slow movement is the 1st presentation in Duchenne muscular dystrophy. ●Gullian barre syndrome afefect nerves ( Motor, sensory ,autonomic) ●Poliomylitis affect anterior horn cells ( Motor only) ●Todd's paralysis occurs in Generalized tonic clonic seizures ● .The most common cause of peripheral hypotonia is WerdingHoffman disease Tachycardia: is the 1st sign of heart failure.  Congenital heart disease is the commonest structural malformation (8:1000 of full term live births)  VSD is the most common congenital heart disease (25-30%)  Congenital acyanotic heart disease is the most common type of congenital heart disease (80%)  Perimembraneous VSD is the most common type of VSD (80%)  Ostium secundum: Most common type of ASD (80%)  Atrioventricular septal defect (AVSD) is the most common cardiac defect in Down syndrome  Commonest site of coarctation of the aorta: just distal to the origin of the left subclavian artery  Rheumatic fever is the most common cause of acquired heart disease in children  Polyarthritis is the most common presentation of rheumatic fever  Carditis is the most serious presentation of rheumatic fever (Endocarditis is the most consistent) (Mitral regurge is the most common lesion)  Rheumatic fever is the most common cause of chorea in children  IM Benzathine penicillin is the best treatment for rheumatic fever  Streptococcus viridians is the most common organism that causes infective endocarditis  Staph. aureus is the most common organism affecting normal heart  (75%) of cases of infective endocarditis occur in patients with preexisting cardiac disease  Failure to thrive and cardiac failure are the most common features in infants with pediatric hypertension VSD: 2nd week of life  Surgical closure of VSD: Infant 6-12 months old with large VSD and pulmonary hypertension  PDA: 2nd week of life  Murmur of PDA: appears after the 1st week of life  Ostium primum (ASD): Infancy  Ostium secundum (ASD): usually in the 3rd or 4th decades  Ostium primum surgery: between 3-5 years  Atrioventricular septal defect (AVSD) surgery: 3-6 months of age  Tetralogy of fallot: delayed: 3-4 months  Clubbing in fallot: 1-2 years  Total surgical correction of fallot: 6-9 months  TGA: early: within the 1 st few hours or days of life  Clubbing in TGA: >1 year in survivors  Surgical repair of TGA: within the 1st 2-3 weeks of life  Rheumatic fever: peak: 5-15 years (All ages can be affected except infancy)  Innocent cardiac murmurs: 30% of children below the age of 5 years  Icteric hepatitis is the most common form of acute hepatitis  Fulminant hepatitis: Acute liver failure is the least common type of acute hepatitis but the most serious (70% mortality)  Nonalcoholic fatty liver disease is the most common cause of chronic hepatitis in developed countries  The most common causes of chronic hepatitis are post viral hepatitis (B, C, D) followed by auto immune hepatitis  The most common cause of neonatal cholestasis is idiopathic neonatal hepatitis (giant cell hepatitis) {Extra hepatic biliary atresia is the 2nd most common cause}  Liver biopsy is the most important investigation to determine the cause of neonatal cholestasis  Biliary atresia is the commonest indication for liver transplantation in infancy  Omphalitis (thrombophlebitis of the umbilical vain) is the most common cause of portal vein thrombosis >>> prehepatic portal hypertension  Hematemesis from esophageal varices may be the 1st presenting symptom of portal hypertension Urinary tract infection (pyelonephritis & cystitis) is the most common non glomerular cause of hematuria  E. coli is the most common cause of urinary tract infection  Toxic synovitis of the hip is the commonest cause of unilateral hip pain and limping in children  Juvenile dermatomyositis (JDM) is the most common inflammatory myositis in children  Corticosteroids: the mainstay of treatment of JDM and sarcoidosis  Familial Mediterranean fever (FMF) is the most common hereditary disease known  Henoch-Schonlein purpura (HSP) is the most common vasculitis in childhood  Palpable purpura (in absence of coagulopathy and thrombocytopenia) is the hallmark of Henoch-Schonlein purpura  Neonatal biochemical screening: after initiation of milk feeding between the 3rd and the 8th day  MRI is done in case of hypoxic ischemic encephalopathy at 414 days  Physiological jaundice 2 nd or 3rd day  Pathological jaundice 1 st 24 hours or later  Breastfeeding failure jaundice: 1 st week of life  Breast milk jaundice: starts at age of 3-5 days; peaks at 2 weeks  25% of neonates ≤34 weeks gestation age have at least 1 apneic spell  Almost all prematures ≤28 weeks have apnea  Hypoglycemia 1 st 72 hours of life  Hypocalcemia: early (1st 3 days of life); late (after the 1st 3 days of life)  Hemorrhagic disease of the newborn: early (2-7 days); late (412 weeks)  Neonatal anemia: usually noticed at 8-12 weeks of age  CMV infection can be diagnosed within 2-3 weeks after birth  Neonatal septicemia: early (less than 72 hours of life); late (more than 72 hours of life)  Swelling in: -Caput succedaneum: at birth; disappear: after 1-2 days -Subgaleal hemorrhage: at birth; " : in weeks Cephalohematoma: 2 nd or 3rd day; " : in weeks  Intracranial hemorrhage: mainly in preterm (40% of preterm below 34 weeks)  The majority of intracranial hemorrhage occur within 1 st 72 hours  Diaphragmatic hernia: intrauterine life (7)  Amniotic gastritis (vomiting of mucoid material): during the 1st few days  Blood stained vomitus: in the 1st few days  Gastroesophageal reflux: vomiting after the 1st week and persists  Esophageal atresia with trachea-esophageal fistula: vomiting with the 1st feed  Congenital hypertrophic pyloric stenosis: vomiting after 2-3 weeks  Onset of symptoms of congenital hypertrophic pyloric stenosis 2-7 weeks after birth  Celiac disease: 6 months – 2 years  Functional constipation: after neonatal period  Intussusception: 3 month – 3 years (peak = 6 months)  Red currant jelly stools: within 12-24 hours of onset of intussusception  Monilial stomatitis (thrush): most common in neonatal period  Herpetic gingivostomatitis: 1-3 years  Herpangina: >5 years