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
 :


:

:




!!




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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

acute attack

chest infection

chest examination

tachypnea

retractions

severe

wheeses

Nebuliser
2

wheeses

solucortef

aminophylline

arrhytmia

ventilator

orazone syrup


2ry Cushing

Medical Guide

Mucophylline

empirical

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 stools

glycerine supp.

2- peristaltic movment

bisadyl 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