Easy GuidE in PEdiatrics

A/
Measuring
drug doses in pediatrics
B/
Management
of most common diseases
in pediatrics :
Gastroenteritis
Common Cold
Tonsillitis
Chest Examination
Bronchial Asthma
Bronchiolitis
Pneumonia
URTI
Stridor
Fungal Infections
Other abdominal disorders
Nice Times

!!

resistance
:

:
suspension

syrup

congestive tonsillitis

Curisafe suspension 250 mg

( )
:

:
ventolin
salbutamol

sutrim suspension

sytron syrp

orazone syrp

paramol syrp

: :
1/
Gastroenteritis

%

stools
fluidity

Volume

Number of motion
Normal habits

fluidity


stools
liquid or semi liquid
diarrhea
well formed
diarrhea


stools
exclusive
stools

semi liquid
diarrhea
number

fluidity
:
infectious diarrhea

viral
60 %
rota virus

bacterial
20%
shigella
E cloli

parasitic
15%
E histolytica
parentral
infection
tonsillitis
otitis media
:

/

motions
fluidity
/
dehydration
, persistent
/ stools
dysentery

/


motions
/


dehydation
/






:
dehydration
general


:
dehydration
watery stools

%




dehydration


sunken eyes

:
umlicus
anterior superior iliac spine

slowly
very slowly


general conditin
irritable

lethargic

dehydration
severe
moderate
mild

skin pinch

 fontanel


:
dehydration
No dehydration

some dehydration

:

:





(
)








) )








reasses
dehydration
some

no

severe dehydration
severe dehydration

some dehydration


pansol
saline


some

30 ml / kg in 1 hour







ORS


Metabolic acidosis
Vomiting
dehydration

severe

30 ml / kg in 1 hour
40 ml/kg in 2 hours
30 ml / kg in 1 hour


:




Hydrosafe



Motion
Vomiting








:

& paracetamol
Ibuprofen
Paramol


severe

Marcofen supp.

:
Domperidone


Motelium
Motinorm
Farcotilium
=
:

 :


vitamin B6

-Metoclopramide



extrapyramidal manfestaions





antidote

:
Aquaream Zn




villi












Antinal





Nifuroxazide






spectrum


organsim


viral


bacterial
shigella


shigella
nifuroxazide

shigella
Normal flora
course

Smecta
Kapect

Kaolin
Pectin



infection
drainage

infection

Imodium
Lomotil

antimotility drugs


paralytic ileus
Acute urine retention

: dysentery
stools
bacterial/parasitic
infection


stools analysis


blood
Shigella
Sutrim
Septrin
Septazole

-ceftriaxone


Rocephin-Cefaxone-Ceftriaxone

-cefotaxime

Cefotax-Claforan
Entamoeba histolytica
vegetataive forms :
Flagyl-Amrizole-Intophar
-



Cystic form :
Furazol

Dilozole
Dimetrol

2/
Common cold

running nose
nasal obstruction
low grade fever
sneezing
mild cough
disturbed feeding

chest examination
free
transmitted sound

:

Allergic rhinitis

No fever
Itching
+ve FH


1-Nasal decongestants

Lyse drops
Otrivin babay saline drops
vasoconstrictor





atrophy of nasal mucosa

otrivin ped. drops

Balkis ped. drops
Afrin ped. drops
Oxymet ped. drops
:

2-systemic decongestants

vasoconstrictor as pseudoephedrine
+ paracetamol

+ antihistaminic

drops
Triaminic drops
1 drop / kg
Rhinostop drops

irritability
syrup
Sine-up
Actifed
Congestal
Sudophine
Balkis

propyphenazone

intracranial hge

Rhinomol
Pararhinol
Vegaskine


herbal

Guava
Herbal Bronch
Balsm
Broncare



empirical

3- Antipyretics
paracetamol


Paramol syrup
Cetal syrup
cetal
paramol


Cetal drops
Pyral drops
2 drops / kg / dose

Ibuprofen

10 mg / kg / dose

100 mg /5 ml

Brufen syrup
Ultrafen
Marcofen



Marcofen supp.


combination

Megafen
Cetafen
Diclofenac

Cataflam drops
2 drops / kg / dose
3


1-3 mg / kg / day

Dolphin supp.
Baby relief supp.

chronic renal failure

paramol syrup


Marcofen supp.




acetyl salicylic acid
vegaskine ped supp

Reye syndrome


( )
hypersensitivity reactions

antibiotic
viral infection

3/
Tonsillitis

fever
sore throat
cough
dysphagia

abdominal pain
vomiting


fever


common


viral
antibiotic


streptococcal

chest
free

cervical lymph nodes

enlarged tender

mouth examination
tonsils

enlarged congested

pus
tonsillitis
streptoccoal


%

throat swab

pus


streptoccal suppurative

congestive

/





/
Congestive Tonsillitis
1- amoxicllin




antibiotic abuse


ampicillin
amoxicllin

resistance

Hiconcil 250 sus.

Ibiamox 250 sus.
Biomox 250 sus.
Amoxil 250 sus.

2- amoxicillin-clavulanic acid

Augmentin


suppurative












:
Magna-Biotic 312 sus.
Curam 312 sus.
Hibiotic 312 sus.






Magna Biotic



3-Cephalosporines

Velosef 250 sus.

Duricef 250 sus.
Curisafe 250 sus.
Ceporex 250 sus.



cefotax
oral
first generation
ceporex


injection
oral

resistance

 curisafe
severe


Magna Biotic
Suppurative tonsillitis


Rheumatic fever

Pencitard Vial
Retarpen






saline

saline
, forearm
intradermal









indurated

induration


redness









erythromycin

erythrocin 200 sus.

4/
chest examination
Inspection


chest indrawing

intercostal retractions

suprasternal retractions





pneumonia
chest indrawing




History
Examination
Investigations

...
:
respiratory rate

periodic breathing




cut off point





:
:
transmitted sound








:
wheeses
expiration






:
crepitations
inspiration
basal




chest
heart

congenital
VSD

recurrent chest infection

5/
Bronchial Asthma

1
2 3
4
5 6 7
8





:
1
asthama


bronchiolitis

attacks of wheesy chest

bronchiolitis


2


acute attack

chest infection

chest examination

tachypnea
retractions
severe

wheeses

Nebuliser
2





wheeses

solucortef

aminophylline

arrhytmia



ventilator

orazone syrup


3



2ry Cushing


Medical Guide








Mucophylline



empirical





4
chronic treament

Mild intermittent


Fixotide inhaler


Ventolin

6/
Bronchiolitis
viral infection
RSV

respiratory distress
severe
respiratory failure

tachypnea
chest indrawing
intercostal retractions
wheeses
? Asthama

attack
bronchiolitis
recurrent attacks
asthma

asthma
fever
asthma

family history
asthma
wheeses

bronchiloitis

ashma
bronchiloitis


? pneumonia

 pneumonia

toxic
high fever
crepitations


chest x-ray
pneumonia
bronchiolitis
CXR
lung hyperinflated

normal

respiratory distress mild

bronchodilators
ventolin
symptomatic
respiratory distress severe

7/
Pneumonia

signs of respiratory distress

chest indrawing
IMCI
chest indrawing
pneumonia



gurnting
acting ala nasei

pneumonia


high fever





toxic

toxic






infection
crepitations

back
bilateral & basal
secretions

CXR
white patches

fungal
diflucan

corticosteroids

8/
URTI







cefotax


tachypneal

retractions









upper respiratory tract infection

bronchitis
pneumonia

CXR

1-antipyretics

2-antibiotics
viral

oral

curisafe
3
Mucolytic

secretions

mucolytic

neonate
Ambroxol drops
Bisolvon drops
Bronchopro drops
Solvin drops

1 drop / kg / dose t.d.s

Mucosol syrup
Bisolvon syrup
Bronchopro syrup
Solvin syrup
Ambroxol syrup
Mucofar syrup




Cough expectorant


cough reflex
immature

Toplexil syrup
All-Vent syrup
Bronchophane syrup
Avipect syrup
Bronex drops
antitussive
suppresion
cough center

Tussilar
Silomat
Selgon
Natural

9/
stridor

mist therapy





hypersensitivity reactions

orazone

10/
oropharngeal candidiasis
thrush
moniliasis


white plaques


tongue depressor

neonates

fungistatin drops
nystatin drops
mycostatin drops


infants & older children
miconaz oral gel

daktarin oral gel

:
1 2
3 nipple & areola

11/
apthous ulcer





bbc spray /
jogel gel /mundisal gel

12/
regurgitation


expulsion of contents of stomach
vomiting :

effortless
contraction of
abdominal muscles

nausea


" "

physiological




happy spitter



:


flat

) )

eructation of air




pathological
gerd
hiatal hernia
achalsia
esophageal atresia

1 2 regurgitation 3
investigation

13/
vomiting


differntial diagnosis



vomiting
exclude
meningitis sensorium

lethargy
fontanell

fever
signs of meningeal irritation


intestinal obstruction

 distension

vomiting


symptomatic


vomiting

vomiting
gastroenteritis
diarrhea

vomiting
acute

overweight

pansol ge
: :



extrapyramidal

motinorm syrup

1 4/
abdominal colics & distension

neonate & infants




percussion
umbilicus
hyperresonant

non specific

symptomatic +

obstruction

 abnormal
severe
organic
pyloric stenosis
us

:




aqua-vera syrup
gripe-wate syrup
nonoo syrup
aqu-cure syrup
aqua-baby syrup


spasmotal drops


paralytic ileus

dentinox drops
baby rest drops
simethicone drops

15 /
intussusception

 telescoping

distal

1-attacks of sharp abdominal pain

2-vomiting
3-red current jelly stools

jelly like
red stools

1-dehydration

2-abdominal distension
3-abdominal mass

abdominal pain

+ red stools



history
examination
pr
red stools


target sign
conservative
reduction
bariumsaline
reduction

obstruction
reduction


reduction

 obstruction
stools

dehydration



aware

16/
malasbsorption






stool analysis

undigested fibers


digestin syrup



visceralgine syrup

17/
abdominal pain
acuta abdomen

us

intussception
strangulated hernia
testicular torsion
appendictis
blood glucose
dka

 recurrent

1
parasites






giradia

parasites specific
stool analysis
2
uti
suprapubic pain

3
acute hepatitis a rt hypochondrial pain
+ fever, malaise

jaundice

 mild

change of color in urine & stools
4
empyema

irritationdiapgragm

chest
pain chest x-ray
5
henoch schonlein purpura
purpura
6
irritable bowel syndrome

( functiona (non organic

investigations

assurance + symptomatic treatment

18/
constipation
infrequent passage of hard dry stools


infrequent


-
-
laxative

difficulty

nelson

functional & organic

functional
%
? functional

functiona
organic

assurance


:




orange juice



bran tab.

regular toilet training

1 softening of stoolsglycerine supp.
2 peristaltic movmentbisadyl supp.
Picolax drops
3-osmotic laxative
duphalac syrup
lactulose syrup




4- natural fibers
agiolax sacchets
importal sachets

5- domperidone ( motilium )


organic

1- obstruction
hirschsprung
intussusceotion
2-anal
anal fissure
perianal dermatitis
3-neuro
cerebral palsy
spinal cord lesion
4-endocrine
hypothyroidism
5-hypotonia
down
6-drugs

organic

history

examination
investigations if needed
history
1 meconium

hirschsprung
2

obstruction
3
examination
1- wt


2- pr
intussception
3-abdomen
masses


functional
organic
us abdomen

 normal





ba enema
colonoscopy

:
/
:
/ dr_hero
:
/