GENERAL PRACTICE Part 2
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GENERAL PRACTICE Part 2 I Dear Student, Welcome to “part general practice - Pediatrics- which is divided into 12 chapters including; Perinatology, Respiratory Problems, Cardiology, Hematology, Oncology, Infec- tion, Endocrinal Diseases, Gastroenterology, Metabolism, Urology, Genetics & followed by Multiple choice Questions, in a simple, illustrative way to make it easy to understand also it contains illustrative diagrams, photos and tables. Most of the topics represent the major categories of diseases e.g. what investigations to do on facing new couple going to marry, how to do fetal assessment, estimation of gestational age, the normal and abnormal findings of baby at birth, the congenital anomalies including the AD, AR, X- Linked and the multifactorial disorders. Birth injuries. How to do resuscitation of the baby. The technique of umbilical catheterization. The at risk pregnancy and intrauterine infection, prematurity, neonatal jaundice and how to dealwith, the neonatal convulsi- ons and how to manage, the respiratory problems of neonate and how to do mechanic- al ventilation, the congenital heart diseases and treatment of heart failure, the common childhood malignancies of blood, bones, brain, eye & kidney. The vaccination, infant development, child abuse, and poisoning in the last chapter. Therefore, after reading this book, you are encouraged to read books on different medical fields, because the book conceived when the previous curriculum was being implemented. In writing this book. I have tried to make it as clear & as brief as possible. Since too much brevity may compromise understanding, i have been a bit “liberal” in some areas including some details ẃ are necessary for the general practitioner’s understanding. This is done to encourage understanding rather than memorization. It is intended to be a text-book for medical students junior doctors & even those beyond can use this book for review. Dr Osama Alagamawy, M.B.B.CH, DCH, DTCH, DIS, DHM. II INDEX Chapter I PERINATOLOGY 1 Premarital Counseling 2 Conception 3 Body & Physiologic Changes In Pregnancy 6 Stages of Labor 7 Fetal Assessment 9 Estimation of Gestational Age 15 Primitive Reflexes 18 Baby After Birth 22 Birth Injuries 36 Birth Asphyxia 48 Resuscitation 50 Chapter II PERINATOLOGY II At High Risk Pregnancy 62 Indications for Caesarean Section 78 Intra Uterine Infection 79 Prematurity 95 Small for Gestational Age 104 Large for Gestational Age 107 Post Term Baby 108 Intra Uterine Fetal Death 110 Neonatal Jaundice 111 Necotizing Enterocolitis 126 Neonatal Convulsion 129 Cerebral Palsy 136 Chapter III RESPIRATORY PROBLEMS Transient Tachypnea Neonate 141 Respiratory Distress Syndrome 142 Mechanical Ventilation 151 Meconium Aspiration Syndrome 162 Persistent Pulmonary Hypertension 165 Neonatal Pneumonia 165 Pneumothorax 167 Congenital Diaphragmatic Hernia 169 III INDEX Stridor 171 Tracheo esophageal Fistula 172 Croup 174 Epiglottitis 174 Asthmatic / Wheesy Bronchitis 175 Whooping Cough 176 Chapter IV CARDIOLOGY Congenital Heart Diseases 178 Ventricular Septal Defect 179 Patent Ductus Arteriosus 181 Atrial Septal Defect 182 Pulmonary Stenosis 184 Coarctation of Aorta 185 Aortic Stenosis 187 Fallot Tetralogy 189 Transposition of Great Arteries 190 Truncus Arteriosus 191 Tricuspid Atresia 192 Total Anomalies Pulmonary Venous Return 194 Heart Failure 195 Chapter V HEMATOLOGY Anaemia 200 Iron Deficiency Anaemia 206 Pernicious Anaemia 208 Folic Acid Deficiency Anaemia 209 Spherocytosis 210 Thalassemia 211 Sickle Cell Anemia 214 Glucose 6 Phosphate Dehydrogenase Deficiency 216 Bleeding Disorders 217 Hemorrhagic Disease of New born 221 Nasal Bleeding 221 Hematemesis 222 Hemophilia 223 IV INDEX Von Willebrand Disease 224 Henoch Schonlein Purpura 227 Idiopathic Thrombocytopenia Purpura 228 Chapter VI ONCOLOGY Leukemia 230 Lymphoma 240 Brain Tumors 241 Bone Tumors 243 Wilm`s Tumor 246 Neuroblastoma 248 Retinoblastoma 250 CHAPTER VII INFECTION Introduction 252 Chicken Pox 254 Measles 256 German Measles 257 Fifth Disease 258 Roseola Infantum 258 Kawasaki Disease 259 Sepsis/Septicemia/Meningitis 260 Neonatal tetanus 266 Osteomyelitis 268 Polio 269 Mumps 270 Tonsillitis 271 Scarlet Fever 272 Erysipelas 272 Infectious Mononucleosis 274 Diphtheria 274 Otitis Media 276 V INDEX Chapter VIII ENDOCRINAL DISEASES Congenital Hypothyroidism 280 Congenital Adrenal Hyperplasia 281 Hypopituitarism 284 Syndrome of Inappropriate Anti Diuretic Hormone 285 Cushing Syndrome 287 Chapter IX GASTROENTEROLOGY & METABOLISM Vomiting 289 Gastro esophageal reflux 289 Hirschsprung Disease 291 Diarrhoea 292 Marasmus 299 Kwashiorkor Disease 299 Inborn Errors of Metabolism 300 Rickets 304 Chapter X UROLOGY Urinary Tract Infection 307 Vesico Ureteric Reflux 308 Nocturnal Enuresis 308 Acute Nephritic Syndrome 309 Post Streptococcal Glomerulonephritis 311 Hematuria 313 Nephrotic Syndrome 314 Renal Failure Neonate 317 Chapter XI GENETICS Introduction 321 Chromosomal Anomalies 323 Autosomal Dominant Disorders 331 Autosomal Recessive Disorders 340 X Linked Dominant Disorders 348 X Linked Recessive Disorders 351 Multifactorial Disorders 356 VI INDEX Chapter XII Vaccination 374 Weaning 379 Infant Development 381 12 Reasons Baby Cry 392 6 Serious Baby Symptoms 394 Child Abuse 395 Poisoning 400 Multple choice Questions 405 Answers 448 References 473 VII ALPHABETICAL INDEX Abrasions 37 Achondroplasia 337 Acute Nephritic Syndrome 309 Alagille Syndrome 336 Albinism 343 Alpha-1- Antitrypsin Deficiency 303 Alport Syndrome 354 Amniocentesis 12 Amniotic Fluid Embolism 75 Anaemia 200 Anencephaly 362 Angelman Syndrome 328 Ankyloglossia 25 Aortic Stenosis 191 Apert Syndrome 339 Apgar Score 49 Asthmatic or Wheezy Bronchitis 175 At High Risk Pregnancy 62 Atopic Dermatitis 33 Atrial Septal Defect 182 Autism 368 Babiniski`s Sign 20 Baby Acne 31 Baby Eczema 31 Bardet Biedl Syndrome 346 Beckwith Weidman Syndrome 335 Birth Asphyxia 48 Birth Injuries 36 Bladder Exstrophy 364 Bleeding Disorders 217 Body & Physiological Changes 6 Bone Tumor 243 Botulism 297 Brachial Plexus Injuries 45 Brachycephaly 332 VIII ALPHABETICAL INDEX Brain Tumors 241 Breast Abscess 27 Café Au Lait Spots 35 Caput Succedaneum 38 Cephalohaematoma 38 Cerebral Palsy 136 Charcot Marie Tooth Disease 333 Chicken Pox 254 Child Abuse 395 Cholera 296 Cleido Cranial Dysplasia 338 Coarctation of Aorta 185 Cockayne Syndrome 347 Coeliac Disease 293 Cohen Syndrome 346 Colladan Baby 34 Color Blindness 352 Conception 3 Congenital Adrenal Hyperplasia 281 Congenital CMV 80 Congenital Cryptorchidism 368 Congenital Diaphragmatic Hernia 169 Congenital Dislocation of Hip 358 Congenital Hepatits B 85 Congenital Herpes Simplex 83 Congenital Human Immune Deficiency Virus 90 Congenital Hydrocele 366 Congenital Hypertrophic Pyloric Stenosis 299 Congenital Hypothyroidism 280 Congenital Indirect Inguinal Hernia 368 Congenital Rubella Syndrome 82 Congenital Syphilis 88 Congenital Talipes Equinovarus 357 Congenital Toxoplasmosis 92 IX ALPHABETICAL INDEX Congenital Umbilical Hernia 367 Conjunctivitis 94 Cornelia De Lnge Syndrome 350 Craniocynostosis 331 Cri Du Chat Syndrome 329 Crohn`s Disease 295 Croup 174 Crouzon Syndrome 337 Cryptorchidism 368 Cushing Syndrome 287 Cutis Marmorata 29 Cystic Fibrosis 341, 294 Cytomegalo Virus Infection 80 Development 381 Diabetic Mother 65 Diaper Dermatitis 32 Diarrhea 292 Diastasis Recti 27 Di George Syndrome 327 Diphtheria 274 Disorders of Sex Development 366 Down Syndrome 323 Duchenne Muscular Dystrophy 353 Eclampsia 68 Ehler Danlos Syndrome 334 Ewing`s Sarcoma 247 Epiglottitis 174 Erb-Duchenne Palsy 45 Erysipelas 272 Erythema Toxicum Neonatorum 28 Estimation of Gestational Age 15 Exomphalos 363 Facial Brusing 24 Facial Nerve Palsy 44 X ALPHABETICAL INDEX Fallot Tetralogy 189 Familial Mediterranean Fever 341 Fat Necrosis 37 Fifth Disease 258 Fetal Assessment 9 Folic Acid Deficiency Anaemia 209 Fracture Clavicle 44 Fragile X Syndrome 349 Galactosaemia 301 Galant Reflex 21 Gastro Oesophageal Reflux 289 Gastroschissis 343 German Measles 257, 82 Glucose 6 Phosphate Dehydrogenase Deficiency 114, 216 Glycogen Storage Disease 304 Hare Lip/Cleft Palate 358 Heart Failure 195 Heat Rash 30 Haemangioma 34 Hematemesis 222 Hematuria 313 Hemophilia 223 Hemorrhagic Disease of Newborn 224 Henoch Schonlein Purpura 227 Hepatitis B 85 Hereditary Fructosemia 304 Herpes Simplex Virus 83 Hirschsprung Disease 291 Human Immune Deficiency Syndrome 90 Hunter Disease 355 Hurler Syndrome 345 Hydrocele 366 Hydrocephalus 356 Hydrops Fetalis 72 XI ALPHABETICAL INDEX Hyperactive Child 370 Hypertensive Mother 67 Hypophosphatemic Rickets 350 Hypopituitarism 284 Hypospadias 366 Idiopathic Thrombocytopenic Purpura 228 Imperforate Anus 363 Inborn Errors of Metabolism 300 Indirect Inguinal Hernia 368 Infant Development 381 Infectious Mononucleosis 274 Intra Cranial Hemorrhage 40 Intra Uterine Fetal Death 110 Intra Uterine Infection 79 Intracranial Hemorrhage 40 Intra Venous Fluid 102 Iron Deficiency Anaemia 206 Kawasaki Disease 259 Kerer’s Paralyses 47 Kernicterus 121 Klenefelter Syndrome 326 Klumpik`s Palsy 46 Kwashiorkor Disease 299 Large for Gestational Age 107 Lesch Nyhan Syndrome 356 Leukemia 230 Lumbar Puncture 135 Lymphoma 240 Mallory Weiss Syndrome 289 Maple Syrup Urine 302 Marasmus 299 Marfan Syndrome 335 Measles 256 Mechanical Ventilation 151 XII ALPHABETICAL INDEX Meconium Aspiration Syndrome 162 Meningitis 260 Milestones 389 Milia 29 Miliaria 30 Mongolian Spots 32 Moro Reflex 18 Nasal Bleeding 221 Natal Teeth 26 Necrotizing Enterocolitis 126 Neonatal Convulsions 129 Neonatal