Diligence interval cognitive designation -hydrops of the fetus

-edema
40-54 severly challenged
-congestion
55-69 challenged ● Abo incapability
-foreigner
70- 84 below average
Blood chart
85- 114 average
Group a Group b Group Group
115-129 above average ab o
130-144 gifted Red blood A B AB O
cell type
145-159 genius Antibodies Anti -B Anti-A none Anti-A
present Anti-B
150-175 extraordinary genius
Antigen A-antige B-antige A and b none
-autistic people presents n n antigens
The most problems of autistic people- “social
interaction”

1 skill of autistic person- good of swimming Universal donor – O

-They have consisted of environment if not they will be

combative
Diagnostic evaluation:
Hemolytic disease of the newborn
Blood typing
● rh incapability
Management:
-Incapability of mother and fetus
Incapability if the mother (-) ● Phototherapy
fetus (+) ● RhoGAM
-donor of the rh (father) ● Exchange transfusion
-RH can be found in red blood cells
-it won’t affect the first pregnancy
-if mixed the blood of mother and baby Hemophilia
-medicatiom: rogum can emphasized the
antibodies/ inject in the first 72 hours -is called a x-linked disorder
Rogum must be given to those parents who has -classic sign: bleeding of the urine (hematuria)
rh antibodies
-rhogum must need to be test before indication - manifest of the disorder(male)
(coobs test) direct and indirect.
-courier (female)
-testing mother blood- mother
-Testing fatal blood to antibodies: direct - female can manifest if both parents should be positive
-if positive of direct (hymolysis) for the disorder.
-if positive for indirect
If negative can be given rhogom -disease of the royalty
● erythroblastosis fetalis -the most common site of bleeding of hemophilia-
-hymolytic anemia of the fetus knees or elbows
-excessive fluid accumulation
- heart failure due to blood/raptured -hallmark of hemophilia: hemarthrosis (bleeding joints)
- heart can be compensate

● Hydrops fetalis
 Types of sickle cell crisis:
Types ● Vaso-occlusive crisis
● Factor VII or hemophilia A (classic hemophilia) Problem: dehydration/ can cause
● FACTOR IX or hemophilia B (Christmas disesase) vasoconstriction
● Factor XI or hemophilia C- most common site of Management: pain on the patient/ give
hymo/ gums analgesic if pain occurs/ administer IV fluid/
increase Oxygen
Manifestation
Demerol- can cause the blood acidic
● Prolonged bleeding Morphine best second to the analgesic if
● Hemorrhage forms any trauma pain occurs
● Easy bruising ● Sequestration crisis
● Hemarthrosis (hallmark sign)
-main problem is hypovolemia
● Spontaneous hematuria (classic sign)
-not because of bleeding but the circulating
blood volume decrease because all the
Management
blood are on the spleen and liver
-if liver and spleen have lots of volume of
Replacement of the missing factor the blood it will bigger.
⮚ Factor VII concentrate -it would be accompanied with
⮚ Cryoprecipitate hepatosplenomegaly
⮚ DDVAP or 1 deamino-8-D arginine vasopressin -splenectomy- opsi (overwhelming
splenectomy infection)
● Aplastic crisis
Prevent bleeding -production of the red blood cell
⮚ Provide safe environment -cause farbo
⮚ No contact sports -lifespan of the rbc will be lessen (10- 20
⮚ Soft bristle toothbrush days) if normal (4months)
● Hypermitotic crisis
Recognize and control bleeding
-can cause jaundice
⮚ Assess the site
⮚ Stabilize Diagnostic evaluation
● Sickledex (sickle turbidity test)
Sickle cell anemia
-disorder of the oxygen capacity carrying of the blood ● Hgb electrophoresis
-no problem of the production

-main problem: the shape of the RBC is different. Management:

Manifestation ● Bed rest

● Oral and iv hydration
General
● Electrolyte replacement
● Growth retardation ● Analgesic for pain
● Chronic anemia ● Blood replacement
● Delayed sexual maturation ● Antibiotics
● Marked susceptibility to sepsis ● O2
● Exchange transfusion with o2 therapy
 Intrauterine Pulmonic stenosis
3 bypasses
● Ductus arteriosus Manifestation
-bypass to the lungs
● May have some cyanosis of CHF
● Ductus denosous
● Characteristics murmur
-detoxifies the oxygen ● Evident cardiomegaly
● Foramen ovale
-not that significant
Acyanotic heart defects Management

1atrial septal defects ● Balloon angioplasty

Manifestation
Aortic stenosis
● Patient may be asymptomatic
Manifestation
● RV and PA enlarges ● Decrease cardiac output
Ventricular septal defects ● Faint pulses, hypotension, tachycardia
● Chest pain
-enlarges of ventricle ● Characteristics murmur
● Infection
Manifestation
Cyanotic heart defects
● Chf
● Bacterial endocarditis Tetralogy of Fallot
● Ventricular hypertrophy
● Ventricular septal defect
Patent ductus arteriosus ● Right ventricular hypertrophy
● Pulmonic stenosis
● Overriding the aorta
Manifestation
Signs and symptoms
● May be asymptomatic
● Difficulty with feeding
● Characteristics Machinery like murmur
● Failure to thrive
● Pulmonary vascular obstructive disease
● Episodes of bluish pale skin during crying or
Management feeding
● Exertional dyspnea, usually worsening of age
● Indomethacin/ ibufropen ● QRS prolongation may result from right
● Surgical ligation ventricular dilation
Coartation of the aorta Management:
● Narrowed segment of aorta Pallative
● Manifestation
● High bp -blalock Taussig shunt
● Low bp a. to provide mixing
● Bounding pulse
Blalock-Hanlon operation
● Signs of arterial insufficiency
b. complete repair
-jatene operation/ complete repair

Management for congenital heart defects Drugs:

● Position ● Penicillin
● Oxygen therapy ● Erythromycin
● Salicylates
● Small frequent feedings
● Phrophylactic treatment
● No constrictive clothing
● Prepare for surgery Kawasaki disease
● Drugs Diagnostic criteria
Cardiac glycoside
Diueretics 1.changes in peripheral extremities
Prostaglandin E Polymorphous exanthema

Bilateral,painless, bulbar conjunctival infection

Diagnostic exam
● Ecg
Management:
● Cardiac catherization
High doe of IV gamma globin

Rheumatic heart failure

Cystic fibrosis
General manifestation:
Manifestation
● Low grade fever
● Unexplained epistaxis ● Meconium ileus
● Abdominal pain ● Thick bronchial secretions
● Arthalgia without arthritic changes ● Increased sweet chlorides
● Weakness ● Decrease fertility in females
● Fatigue ● Sterility in males
Major manifestation Acute epiglottitis
● Carditis ● Manifestation
● Migratory polyarthritis ● High fever
● Chorea ● Sore throat
● Subcutaneous nodule ● Dysphagia
● Muffled voice but no hoarseness
Diagnostic evaluation
● Inspiratory stridor
● Jones criteria ● Drooling
● Aso titer
Laryngotracheobronchitis
● Esr
Manifestation

● Inspiratory stridor
● Suprasternal retractions
Management: ● Seal bark cough
● Progressive hoarseness, followed by aphonia
Strict bed rest ● Nasal flaring
 ● Hypoxia Projectile vomiting

Management

● Corticosteroids
● Maintain hydration
● Intubation if needed
● Semi fowler's position Management
Cleft lip/ cleft palate Pyloromyotomy
a. Surgical correction
-cleft lip at age 2 months
- cleft palate-at age 18 months or older

Preoperative care: Celiac disease

● Cleft up Manifestation
● Application of logan bow ● Impaired fat nutrients absorption
● Elbow restraints ● Behavioral changes
● Diet: clear liquids ● Celiac crisis
● Prevent crying
● Cleanse it free from serosanguinous fluid Diagnostic evaluation

Tracheosephageal fistula and atresia Jejunal biopsy

Manifestation:

Excessive salviation

Fiagnostic evaluation Intussusception

Aspiration of stomach contents or introduction Manifestation

Sudden acute abdominal pain

Passage of red currant jelly like stool

Tender distended abdomen

Palpable sausage shaped mass in RUQ

Diagnostic evaluation

Management

● Barium enema
● Pneumatic insufflation
● Laparotomy

Hypertrophic pyloric stenosis Hirschsprung’s disease

Manifestations Manifestation:
 ● Failure to pass meconium
● Reluctant to inject food
● Bile-stained vomitus
● Abdominal distention
● Foul breath
● Ribbon like peristalsis
● Palpable fecal mass
● Diagnostic evaluation

Xray

Management:

colostomy

soave endorectal pull through procedure