Pediatric

Pediatric صفحة خاصة بيا للدراسة
مبروكة عمر سالم
MRCPH

*HSP* is typically a self-limited disease and presents with a *classic tetrad:*Palpable purpura *WITHOUT* thrombocytopen...
21/02/2026

*HSP* is typically a self-limited disease and presents with a *classic tetrad:*
Palpable purpura *WITHOUT* thrombocytopenia or coagulopathy – Non-blanching rash, mainly on buttocks and lower limbs
*Arthralgia or arthritis* – Commonly knees and ankles – Non-erosive and transient
*Abdominal pain* – Colicky pain – May cause GI bleeding – Serious complication: intussusception
*Renal* involvement – Microscopic hematuria most common – May progress to nephritic or rarely nephrotic syndrome – Severe cases → rapidly progressive (crescentic) glomerulonephritis*Renal* involvement may appear *late* , even after rash resolves.
Renal involvement typically appears within the first 4–8 weeks, but may develop up to 6 months after onset.
*Recommended monitoring:*
Weekly for 1 month
Every 2 weeks until 3 months
Then at 6 and 12 months
*Check* :
Blood pressure
Urinalysis (hematuria, proteinuria)
Serum creatinine if abnormal findings*Renal disease determines prognosis* in HSP — not the rash.
Development of hypertension, ≥2+ proteinuria, macroscopic hematuria, or nephritic/nephrotic features requires urgent evaluation.
*Even if initial urinalysis is normal,* continue follow-up for at least 6 months (exam favorite).
*Recurrent HSP* episodes are monitored *as a first episode.*

**5 months baby with *proteus UTI* *us done and MCUG* , received antibiotics and improved. What is *next* investigatio...
22/01/2026

**5 months baby with *proteus UTI* *us done and MCUG* , received antibiotics and improved. What is *next* investigation?

a) DMSA
b) Mag3.
c) Cystoscopy.
d) Catheter.
e) KUB kidney and ureter.
A

*Simple UTI* :
responds within 48 hr
 *Atypical UTI:*
 seriously ill child
 poor urine flow
 abdominal or bladder mass
 raised creatinine
 septicaemia
 failure to respond to treatment within 48 hr
 infection with organisms other than E. coli

 *Recurrent UTI:*

 ≥2 episodes of UTI with acute pyelonephritis/upper UTI
 1 episode of UTI with acute pyelonephritis/upper UTI plus ≥1 episode or UTI with cystitis/lower UTI
 ≥3 episodes or UTI with cystitis/lower UTI

29/12/2025

12-year-old girl with Type 1 Diabetes Mellitus has poor glycemic control despite increasing insulin dose to 1.5 U/kg/day.

has weight loss, recurrent abdominal pain, and abdominal distension.
*Investigations* :
Hb: 10.8 g/dL (low)
MCV: 66 fL (low)
MCH: normal
HbA1c: 88 mmol/mol (very high)
*Question* :
investigation will most likely lead to the diagnosis?
*Correct Answer* b) Anti-tissue transglutaminase antibodies

with Type 1 DM have a high risk of associated autoimmune diseases, especially celiac disease.

Poor glycemic control despite high insulin doses + weight loss + GI symptoms *strongly suggest* malabsorption.

anemia* with GI symptoms further supports celiac disease.

-tTG antibodies* are the *best initial screening* test.⭕ *Screen* with anti-tTG antibodies ( *even* if *asymptomatic* )

28/12/2025

A 4-year-old girl is newly diagnosed with oligoarticular juvenile idiopathic arthritis (JIA).
The rheumatology consultant refers the child to another department.
The father asks: Which department

ophalamology

⭕Children with *oligoarticular JIA* are at
high risk of *chronic anterior uveitis* , which is often asymptomatic but can cause permanent vision loss if not detected early.

⭕*Regular* ophthalmologic *screening* is mandatory,
*even* in the absence of eye symptoms.

⭕*Oligoarticular* JIA = *automatic ophthalmology referral.*The presence of a positive ANA confers increased risk for asymptomatic anterior uveitis, requiring periodic slit-lamp examination.

The screening recommendations for children with oligoarticular, polyarticular, psoriatic, and undifferentiated JIA are as follows:

●Age at onset 4 and 7 years – Eye examination every 12 months

28/12/2025

Clinical Scenario:

A 2-year-old presents with Fever 39°C), lethargy, vomiting x24h

Received 2x NS boluses (20mL/kg each). Vital Signs:

HR: 185→ 200/min (persistent tachycardia)

RR: 45→ 55/min (tachypnea)

BP: 80/60 78/58 mmHg (mild hypotension)

CRT: 3 sec (unchanged post-fluids)

No hepatomegaly or crackles on exam

Question:

What is the most likely underlying pathophysiology? Options:

a) Intravascular volume depletion

c) Systemic vasodilation.

e) Neurogenic shock

b) Myocardial dysfunction
d) Obstructive shock

-induced myocardial dysfunction

Persistent shock after 40–60 mL/kg fluids in a septic child strongly suggests myocardial dysfunction

so can start inotropesvasodilation means (warm shock) so Warm extremities, brisk CRT.

Address

Sirt

Website

Alerts

Be the first to know and let us send you an email when Pediatric posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Shortcuts

Share

Category