DIFFERENTIATE BETWEEN

CHARACTERISTICS LIVE VACCINE KILLED VACCINE

AGENT USED Live attended organism Killed organism

DURATION OF IMMUNITY longer Shorter

IMMUNOGLOBULINS IgA ,IgG IgG

PRODUCED

EFFECTIVENESS OF greater lower

PROTECTION
BOOSTER IMMUNISATION Not required Required

COLD CHAIN required Required

COST Less cost costly

CELL MEDIATE IMMUNITY yes No

PRODUCED
ADJUVANT Not required required

ANTERIOR FONTANELLE POSTERIOR FONTANELLE

ALSO CALLED Bregma Lambda
LOCATION Found at junction of sagittal, Situated at junction of
coronal and frontal sutures. lambdoidal and sagittal
sutures.
SHAPE Broad kite / diamond shaped Small triangular shape
TYPE Soft membrane floor Bony floor
AGE OF CLOSURE 18 months 6 to 8 weeks
 TUBERCULOUS
FEATURES MENINGITIS
DEFINITION It is a form of meningitis Inflammation of brain and spinal cord
characterized by typically caused by an infection
inflammation of the
membranes caused by
specific bacterium known as
Mycobacterium Tuberculosis.
CLINICAL • Headache
FEATURES • Behavioural changes
• Fever
• Stiff neck
• Vomiting
• Irritability, drowsiness
• Stupor, possibly
leading to coma.
DIAGNOSTIC TESTS • Based on clinical
presentation
• Neuro imaging
characteristics.
• CSF examination
• HIV serology
• Culture of body
fluids.
• Other radiographic
studies
TREATMENT • Anti tubercular
treatment for 12
weeks
• Steroid therapy
• Supportive and
symptomatic therapy
COMMUNICATIVE HYDROCEPHALUS NON COMMUNICATIVE HYDROCEPHALUS
• Obstruction in the subarachnoid space.
• Causes post hemorrhage, bacterial meningitis,
malignant meningitis.
• Doesn’t prevent the ventricles from
communicating with the subarachnoid space.
• Occurs when the CSF flows out of the
ventricle and into the spinal canal but not
reabsorbed normally by the tissue
surrounding the brain and the spinal cord.
BACTERIAL MENINGITIS
• Pain in back, muscles or neck.
• Fever,chills,fatigue,lethargy.
• Nausea, vomiting.
• Blotchy or red lashes.
• Irritability, headache, stiff neck.
• Bulging fontanelle, mental
confusion.
• History collection
• CSF examination
• Polymerase Chain Reaction
• Rapid Diagnostic Tests
• Serologic studies
• Histopathology
• Other lab studies
• Antibiotics
(cefotaxime,ceftriaxone)
• Anti inflammatory therapy
( Dexamethasone)
• Anti convulsants
• Called internal, obstructive, non
communicating hydrocephalus.
• Obstruction within ventricular system.
• Causes include congenital and acquired.
• The ventricles are not in communication with
subarachnoid space.
• Occlusion usually occurs in cerebral
acquiduct.
DISEASE GLAUCOMA
CHARACTERISTICS
Glaucoma is a group of eye
Definition disorders result in damage to
the optic nerve and causes
vision loss.
Pathophysiological Increased intra ocular
mechanism pressure due to accumulation
of aquous humor in the eye.
Causes Ocular hypertension
Aging
Family history of glaucoma
Types Open angle glaucoma
Angle closure glaucoma
Signs and symptoms Open angle –usually painless
asymptomatic
Angle closure-sudden ocular
pain
Halos around lights
High intra ocular pressure
Redeye
Decreased vision
Fixed mid dilated pupil
Diagnosis History collection
Eye examination
Ophthalmoscopy
Tonometry
Gonioscopy
Perimetry
Nerve fiber analysis
Treatment Argon laser trabeculoplasty
Trabeculectomy
Med;
Prostaglandin analogs
Beta adrenergic receptor
agonists
CATARACT
Cataract is a condition in
which the lens of the eye
become cloudy that leads to a
decreased vision.
Accumulation of protein or
yellow pigment in the lens
that reduces transmission of
light to the retina at the back
of the eye.
Aging
Trauma or radiation
exposure.
Congenital
Following eye surgery
Congenital cataracts
Nuclear cataracts
Cortical cataracts
Posterior subscapular
cataracts
Reduced vision
Blurring
Glare
Amblyopia
History collection
Visual acquity test
Slit lamp exam
Retinal exam
Cataract surgery
[removing clouded lens and
replacing it with artificial
lens
PARAMETER MENINGOCELEE MENINGOMYLECELE

DEFINITION Birth defect in which Failure of closure of neural tube in which a

incomplete closure of cystic swelling occurs over the site of the
backbone and membranes spinal defect which contains meninges, nerve
and around the spinal cord roots and the spinal cord itself which has left
which protrusion that the vertebral canal
includes the meninges and
sac containing CSF
diagram

severity Less common and not very Most severe

severe

Involvement Only meninges are Spinal cord and surrounding meninges are
involved not the spinal involved
cord
REGION lumbosacral region, 85% occur in lumbosacral region
thoracic region and skull

Protrusion That includes meninges Spinal cord and meninges protrudes out the
and a sac contain CSF vertebra

GROWTH DEVELOPMENT

• The increase in cell size and number that
takes place during the life history of an
organism.
• The increase in size and mass over a period of
time.
• A part of development.
• Occurs at cellular level.
• Stops at maturation.
• Can be measured directly.
• Quantitative.
• The progressive changes in size, shape and
function during the life of an organism.
• The transformation of an organism into a
more complex form.
• Includes growth, morphogenesis and
differentiation
• Occurs at organizational level.
• Continues throughout life
• A subjective interpretation.
• Quantitative and qualitative
 CHARACTERISTICS APLASTIC ANEMIA
Definition It is a type of anemia cause
the reduction in the amount
of hematopoietic tissue
causing inability to produce
mature cells for discharge
into blood stream.
Causes • Idiopathic
• Secondary:
idiosyncratic drug,
chemical exposure,
infectious hepatitis
• Congenital: fanconi
anemia, inherited
thrombocytopenia
Types Congenital aplastic anemia
Acquired aplastic anemia
pathophysiology Immune mediated
suppression of marrow
elements led to
activation of Cytotoxic T
cells in blood and marrow
release gamma IFN and TFN
led to inhibit early and late
progenitor cells.
Clinical features Persistant pallor
Prone to infections
Hematameisis, hematurea
Leucopenia
thrombocytopenia
Management Red cell transfusion
Bone marrow transplantation
Immune suppression
Treatment for prevent
infection and hemorrhage.
CHARACTERISTICS OMPHALOCELE
HERNIATED VISCERA Bowel ± liver
SAC Present
ASSOCIATED ANOMALIES Common (50%)
LOCATION OF DEFECT Umbilicus
MODE OF DELIVERY Vaginal/ cesarean
MEGALOBLASTIC ANEMIA
Megaloblastic anemia is a RBC cell
disorder due to the inhibition of
DNA synthesis during
erythropioesis.
VitaminB12 and Cobalamin
deficiency
Folic acid deficiency
a and b deficiency
• 1) Folate-Deficiency Anemia.
• 2) Pernicious Anemia.
• 3) Megaloblastic Anemia and
Vitamin B12.
The underlying feature in
megaloblastic anemia is a block in
DNA synthesis in rapidly
dividing cells. This occurs due to
inability to methylate
deoxyuridylate to thymidylate in
the DNA synthesis pathway.
Anemic symptom; weakness,
palpitation, fatigue, jaundice.
Neurological symptoms
Gastro intestinal symptoms:
diarrhea loss of appetite, red sore
smooth tongue
Increase intake of vit B12. 1 mg of
IM Hydroxycobalamin daily until
reticulocyte recovery after which
the dosing was spaced to once a
week. • The disease can be fatal if
left untreated.
GASRTROSCHISIS
Bowel only
Absent
Uncommon (˂10%)
Right of umbilicus
Vaginal
SURGICAL MANAGEMENT Non urgent Urgent

CHARACTERISTICS CONVULSIONS EPILEPSY

DEFINITION A sudden violent irregular It is a disorder characterized by 2
movement of the body caused by or more unprovoked seizures
massive electrical discharges in a occurring more than 24 hours apart
group of nerve cells in brain leads beyond neonatal period.
to change in mental activities an
behavior.
CLASSIFICATION Generalized : Generalized epilepsies :
• Grand mal • Absence seizure
• Petit mal • Myoclonic seizure
Partial : • Tonic seizure
• Simple • Tonic clonic seizure
• complex • Atonic seizure
Focal epilepsies :
• Simple partial
• Complex partial
• Partial seizure with
secondary generalization.
CAUSES • High fever • Idiopathic
• Infection • Secondary
• Poisoning • Cerebral tumors
• Head injury • Neuro degenerative
• Epilepsy disorders
• Stroke • Neuro cutaneous syndrome
• Hypoxia
CLINICAL MANIFESTATIONS • Twitching of arm or leg • Infantile spasm
• Automation • Benign neonatal
• Confusion convulsion
• Fever • Acquired epileptic aphasia
• Rectal temperature ˃102˚F • Dravet syndrome.
MANAGEMENT • Anti epileptics • Ketogenic diet
• Sedatives • Nerve stimulation therapy
• Fluids • Rational combination
• Oxygen therapy therapy
• Airway management • Monotherapy

HODGKIN’S LYMPHOMA NON HODGKIN’S LYMPHOMA

Lymph malignancy of proliferating germinal center Monoclonal proliferation of B or T lymphocytes
cell.
EBV, predominal age distribution with the first peak EBV, HiV
at
20-30 years.
Reed- Sternberg cells present Reed – Sternberg cells absent
Contagious lymph node spread Non contagious lymph node spread.
Treatment : Treatment :
Chemotherapy Chemotherapy
Adrimycin Adrimycin
Bleomycin Cytoxon
Vincristine Oncorin
Dacarbaxine Prednisone.
LOBAR PNEUMONIA BRONCHO PNEUMONIA
DEFINITION It is a form of pneumonia that It is a form of pneumonia
affects one or more lobes of lungs. characterized by inflammation of
lungs arising in bronchi or
bronchioles.
LOCATION Large area, even whole lobe Often bilateral
involvement Lower lobes
ROUTE OF INFECTION Both alveoli and bronchioles Spreads from bronchioles to
nearby alveoli
SPREAD OF INFECTION Whole lobe becomes consolidated Consolidation is patchy
SUSCEPTIBLE GROUP Middle age 20-50 Extremes of age
Primary, in healthy people Secondary, in sick people
Males common Both genders
CAUSATIVE ORGANISM Often caused by pneumococcus or Dependant on circumstances
klebsiella predisposing to infection
ANATOMIC BOUNDARIES Limited by anatomic boundaries Not limited by abnatomic
boundaries
NODULES Usually absent Centrilobular nodules

DOWN SYNDROME TURNER SYNDROME

DEFINITION It is a genetic disorder caused Condition that affects only female,
when abnormal cell division when one of X chromosome is
results in extra genetic material missing or partially missing.
from chromosome 21.
RISK FACTORS • Advancing maternal • Loss or alternatives of X
age. chromosome occur
• Carrier of genetic randomly
translocation for down
syndrome.
• Having had one child
with down syndrome
SYMPTOMS • Flattened face • Wide or web like neck
• Small head • Swelling on hands or feet
• Protruding tongue • Slowed growth
• Poor muscle tone • Cardiac defects
• Short neck • Short finger and toes
COMPLICATIONS • Heart defects • High BP
• GI defects • Hearing loss
• Immune disorder • Vision problems
• Sleep apnea • Kidney problems
• obesity • Heart problems
TREATMENT Therapies : Hormone therapy :
Speech therapy Growth hormone therapy
Occupational therapy Estrogen therapy
Physical therapy
 Self care

HYPOSPADIAS EPISPADIAS
DEFINITION Hypospadiasis refers to the Epispadiasis is a congenital
urethral opening that is on the malformation in which the opening
ventral surface of the penile shaft of the urethra is on the dorsum of
the penis.
INCIDENCE Occurs in up to 4 in 1000 newborn Occurs in 1 in 1,17,000 newborn
boys. boys and 1 in 484,000 newborn
girls.
CAUSES • Present at birth • Unknown
• Defect in androgen • Related to improper
stimulation of developing development of pubic bone
penis • Failure of abdominal and
• Deficient androgen pelvic fission in the first
production by testes and months of embryogenesis.
placenta
TYPES Anterior hypospadias Glanular epispadias
Posterior hypospadias Penile epispadias
Middle hypospadias Peno pubic epispadias
SYMPTOMS Physical deformity of penis Backward flow of urine to kidney
Abnormal urinary stream Urinary incontinence
Sexual dysfunction UTI
DIAGNOSTIC MEASURES Prenatal ultrasound Prenatal diagnosis
Physical examination of newborn Blood test
Excretory urogram Intravenous pyelogram
TREATMENT Adjuvant hormonal therapy Maximize penile length
Circumcision should be avoided Mitchell’s technique

BRONCHITIS BRONCHIOLITIS
DEFINITION It is a febrile illness characterized by It is a serious illness characterized by
cough and wheezing. It involves inflammation of bronchioles, cause
inflammation of one or more bronchi. severe dyspnea.
CAUSES Rhinovirus Adenovirus
Adenovirus Influenza virus
Chemical agents : Streptococcus hemolyticus
Dust, allergens, strong fumes.
CLINICAL FEATURES Runny nose Dyspnea
Malaise Fever
Chills Cyanosis
Fever Nasal flaring
Wheezing Retractions
Sore throat Wheezing
DIAGNOSTIC History collection & physical History collection & physical
EVALUATION examination examination
X-ray X-ray
 Chest auscultation
MANAGEMENT Antibiotics Antibiotics
Cough expectorants Oxygen administration
Antipyretics IV fluids
Steam inhalation Prevention of dehydration

MENINGITIS
Meningitis is the inflammation of protective layers of
tissue/membranes covering brain.
Caused by bacteria, virus and fungi
Can exist only as a single form
Symptoms include sudden fever, severe head ache,
nausea, vomiting, double vision , drowsiness,
photophobia and stiff neck
Diagnosed by routine blood examinations and
cultures.
Will be treated with ampicillin combined with
aminoglycoside or cephalosporin.
ENCEPHALITIS
It is an acute inflammation of the brain parenchyma.
Commonly caused by viral agents
Can occur as primary or secondary types
Symptoms include moderate – severe fever, seizures,
behavioral changes, confusion, disorientation and
related neurologic signs.
Might need neuro imaging techniques
Will be treated with IV Acyclovir for 10 days

ATRIAL SEPTAL DEFECT VENTRICULAR SEPTAL

DEFECT
DEFINITION An opening in the atrial septum. It An opening in the ventricular
allows oxygenated blood to pass septum. Allows oxygenated blood
from the left atrium, through to pass from the left ventricles,
opening in the septum and then through the opening in the septum
mix with deoxygenated blood in and then mix with deoxygenated
right atrium blood in right ventricle.
CLINICAL MANIFESTATIONS Tachypnea Exertional dyspnea
Tachycardia Heavy and congested breathing
Shortness of breath Excessive sweating
Murmur
DIAGNOSTIC EVALUATION Chest X ray History collection
ECG Physical examination
Echocardiography ECG, Echocardiography
MANAGEMENT Exercise restriction Digoxin
Diuretics Diuretics
Digoxin

PHYSIOLOGICAL JAUNDICE PATHOLOGICAL JAUNDICE

ONSET More than 24 hours Less than 24 hours
DURATION Term : ˂2 weeks Term : ˃2 weeks
Preterm : ˂3 weeks Preterm : ˃ 3 weeks
SERUM BILIRUBIN Raise ˂ 0.2 mg/dL Raise ˃ 0.2 mg/dL
CONCENTRATION
TSB ˂15mg/dL ˃ 15 mg/dL
INVOLVEMENT OF PALMS & No Yes
SOLES
SIGNS OF ACUTE BILIRUBIN No Yes
DIRECT BILIRUBIN ˂2 mg/dL More than 2 mg/dL
CLINICALLY Looks normal, not anemic, not Looks abnormal, anemic, sick and
sick abnormal color of urine and stool
Normal urine and stool color
PHYSICALLY CHALLENGED MENTALLY CHALLENGED
DEFINITION It means some part of the person’s Mentally challenged means some
body does not function. part of person’s mind does not
function.
EXAMPLE Poliomyelitis Mental retardation
Cerebral palsy
Congenital deformities in limbs
Accidents
Spinal cord injuries
TREATMENT Based on disease conditions Proper medication
Physiotherapy Counseling
Other therapies Rehabilitation
medications

CAPUT SUCCIDANEUM CEPHAL HEMATOMA

INCIDENCE Frequent 4 to 25 in 1000 delivery
BIRTH HISTORY Vertex delivery, vaccum Forceps delivery, difficult
extraction delivery, more frequent in males
LOCATION A point of contact can extent Usually over parietal bone, does
across sutures not cross sutures
SIGNS & SYMPTOMS Usually no other symptoms, Usually no other symptoms, skull
resolves in several days fracture, severe blood loss
VOLUME OF BLOOD LOSS Minimal Rarely severe
CHARACTERISTICS Vaguely demarcated, pitting Distinct margins, initially firm,
edema that shift with gravity more fluctuant after 48 hours
PROGNOSIS Excellent Resolve in 2 week to 6 months

CHARACTERTICS TRUST MISTRUST

* The condition and * Lack of trust or
resulting obligation of confidence arising
Definition having confidence from suspicion.
placed in one. * To be suspicious or
* One in which doubtful.
confidence is placed.

If child successfully Sense of mistrust in

Features develop trust, he feels children may perceive
secure. the world is
unpredictable and
inconsistent.
Example Abbie trust Susan, Abbie mistrust Susan,
because Susan has because Susan told
never told anyone, everyone Abbie's
about Abbie's secrets. secret.

CHARACTERISTICS COMPLETE FRACTURE GREEN STICK FRACTURE

Complete fractures are A fracture in which one side of

fractures where the parts of a bone is broken while the other
Definition the bone that have been is bent ( like a green stick )
fractured are completely
separated from each other.

Incidences At any age. Most often during infancy and

childhood when bones are soft.

* Pain * Pain
* Loss of function * Bruising
Symptoms * Deformity * Tenderness
*Shortening * Swelling

* Crepitus * Deformity
* Swelling and discoloration

Treatment * Reduction * Immobilizing the bone with a

cast or splint.
* Internal and external
Fixation * Reduction

* Immobilization * Internal and external fixation

* Splitting and Traction

CHARACTERISTICS KWASHIORKOR MARASMUS

Cause This disease is caused due to severe This disease is caused due to
deficiency of protein. severe deficiency of all nutrients,
primarily carbohydrates.
Calorie intake Normal Inadequate
Peripheral edema Present Absent

Appetite Poor appetite Voracious appetite

Fatty liver Common Uncommon

Skin changes Dermatosis, flaky paint appearance Skin is dry and wrinkled but no
of skin dermatitis.

Subcutaneous Subcutaneous fat is preserved Subcutaneous fat is absent

fat
Hair changes Common Absent
Prognosis Worse prognosis Better prognosis

FEATURES RESPIRATORY MECONIUM ASPIRATION

DISTRESSSYNDROME SYNDROME
(RDS) (MAS)

A breathing disorder in newborns Meconium aspiration syndrome is

caused by immature lungs. Neonatal
Definition respiratory distress syndrome (NRDS)
is more common in premature babies
born six weeks or more before their due
dates. It usually develops within the
first 24 hours after birth.
trouble breathing (respiratory distress)
in a newborn who has breathed
(aspirated) a dark green, sterile fecal
material called meconium into the
lungs before or around the time of
birth.

The most common cause of ARDS is Meconium aspiration happens when a

sepsis, a serious and widespread baby is stressed and gasps while still in
Etiology infection of the bloodstream. the womb, or soon after delivery when
Inhalationof harmfulsubstances. taking those first breaths of air. When
Breathing high concentrations of gasping, a baby may inhale amniotic
smoke or chemical fumes can result in fluid and any meconium in it.
ARDS, as can inhaling (aspirating)
vomit or near-drowning episodes.

Respiratory: respiratory distress, fast Cyanosis.

breathing, shortness of breath, or rapid
breathing.
Clinical Whole body: low oxygen in the body or
features fever. Also common: blue skin from
poor circulation, coughing, high carbon
dioxide levels in blood, muscle
weakness, or organ dysfunction.
End-expiratory grunting.
Alar (nasal) flaring.
Intercostal retractions.
Tachypnea.
Barrel chest (increased anteroposterior
diameter) due to the presence of air
trapping.
Auscultated rales and rhonchi (in
some cases).
 Treatment of ARDS is supportive,
including mechanical ventilation,
Treatment prevention of stress ulcers and venous
thromboembolism, and nutritional
support.
Most patients with ARDS need
sedation, intubation, and ventilation
while the underlying injury is treated.
oxygen therapy to make sure there is
enough oxygen in the blood.
the use of a radiant warmer to help your
baby maintain body temperature.
antibiotics such as ampicillin and
gentamicin to prevent or treat an
infection.
the use of a ventilator (a breathing
machine) to help your infant breathe.

DEFINITION
CAUSED BY
CLINICAL FEATURES
DIAGNOSTIC STUDIES
MEDICAL MANAGEMENT
NURSING MANAGEMENT
DIPHTHERIA PERTUSSIS
It is an acute infectious disease that It is a highly contagious disease
typically strikes the upper respiratory affecting the respiratory tract
tract including throat
Corynebacterium diphtheria Bordetella pertussis
• Onset with fever • Cyanosis
• Malaise • Long inspiratory effort
• Headache accompanied by a high
• Weakness pitched “whoop”.
• Respiratory distress • Vomiting and exhaustion
• Cyanosis • Anorexia
• wheezing • Dehydration
• Difficulty sleeping
• Otitis media
• Gram stain or throat culture • History of typical signs and
• Elek immunodiffusion test symptoms of disease.
• Sterile cotton tipped • Physical examination
applicators • Lab tests include
• ECG nasopharyngeal swabs.
• Throat or lesion culture • Blood test
Erythromycin Adequate nutrition, rest
Antitoxin Oxygenation
Antibiotics Respiratory therapy
Supportive treatment Mechanical ventilation
Antipyretics Antimicrobial therapy
Vaccines
• Droplet isolation • Provide adequate bed rest.
• Encourage fluid, small • Encourage fluid intake
frequent feeds • Monitor signs of airway
• Observe signs of airway obstruction
obstruction • Treat secondary infection
• Bed rest, mental rest

WEANING ARTIFICIAL FEEDING

DEFINITION It is the process of giving infants other Mother who are unable to breastfeed or
foods and liquids along with breast milk who decide not to breast feed, infant
after the age of 6 months. formula is good alternative.
EXAMPLES Liquids-soup of vegetables Cow milk
Semisolids – mashed potato Buffalo milk
Solids – cooked rice Commercially available dried milk
TYPES Child-led weaning Bottle feeding
Mother-led weaning Cup feeding
Katori and spoon feeding
Gastric feeding
ADVANTAGES • Prevent malnutrition • Good for working mothers
• Promotes growth • Provide adequate nutrition
DISADVANTAGES • Diarrhea • Over feeding
• Deficiency of protein, vitamins, • Gastroenteritis
calories

PYLORIC STENOSIS INTESTINAL OBSTRUCTION

DEFINITION It is the narrowing (stenosis) of the It is a partial or complete blockage of the
opening from stomach to the first part bowel that prevents the contents of the
of small intestine known as duodenum. intestine from passing through.
CAUSES • Unknown • Intestinal adhesions
• Genetic & environmental • Bands of fibrous tissue in
factors abdominal cavity
• Hernias
• Colon cancer
SYMPTOMS Vomiting Crampy abdominal pain
Persistent hunger Loss of appetite
Dehydration Constipation
Change in bowel movements Very loud crying
DIAGNOSTIC Blood test Blood test
STUDIES X ray X rays
CT scan CT scans
Abdominal USG Colonoscopy
Barium swallow Enema with contrast
MANAGEMENT pyloromyotomy Treating intussusceptions
Treatment for partial obstruction
Treatment for complete obstruction
Treatment for pseudo obstruction
COMPLICATIONS Failure to grow and develop Tissue death
Dehydration Infection
Stomach irritation
Jaundice (rarely)

TURNER SYNDROME KLINEFELTER SYNDROME

DEFINITION This syndrome is caused by the This syndrome is caused by the
lack of sex chromosome (XO presence of an extra sex
instead of XX) chromosome.(XXY instead of
XY).
OCCURRENCE 1 in 2500 phenotypic females 1 in 1100 phenotypic males
SYMPTOMS Lymphedema Enlarged breasts
Underweight Undeveloped penis and testes
Swelling or thickness of neck
GONADAL SEX Absent Are present and are atrophied
PHENOTYPE Underdeveloped breast Presence of penis, vas deferens
Absence of menstrual cycles and seminal vesicles but are
Presence of vagina, vulva and inactive
uterus.
TREATMENT No cure Fertility treatment
Replacement therapy Counseling
Estrogen and growth hormones Removal of excessive breast tissue
Hormonal replacement therapy
Support and educational
evaluation.

CRITERIA NEGATIVISM SIBLING RIVALRY

DEFINITION Negativism is defined as doing the Sibling rivalry is defined as the

opposite of what others want,is normal competition or animosity between
for toddlers brothers and sisters

CAUSES The child's desire for independence Jealousy

feelings of frustration and anger when two siblings are close in age
The exciting and frightening competition over similar interest and
goals

STRATEGIES FOR Redirect the child Respect each child as unique

PREVENTION Encourage talking Be an impartial mediator
Giving choices schedule special time with each child

EXAMPLE Saying No ! Fighting for toys

Refusing to do anything ,you want them
to

EMPHYSEMA EMPYEMA
DEFINITION Chronic progressive lung disease • An empyema is a collection
where tissues supporting lungs are of pus within a body cavity
destroyed
CAUSES • Smoking • Pneumonia
• Air pollution • Rupture of lung abscess
• Hereditary factors • Rupture of subphrenic
• Male gender abscess
• Asthma • Tb
• Allergies • Secondary infection during
aspiration of pleural fluid
SYMPTOMS • Severe dyspnea • Fever
DIAGNOSTIC STUDIES • Examining pulmonary function • Lab investigation :cbc, blood
 by spirometry culture, serum LDH

• Radiographic studies
MANAGEMENT • Corticosteroids • Cefuroxime
• Metronidazole
• Positioning • Benzyl penicillin
• ciprofloxacin
• O2O2lung transplantation • Amoxycillin
• Clindamycin

UNDER FIVE CLINIC CHILD GUIDANCE CLINIC

✓ Under- five clinic • Under five clinic is a ✓ Child Guidance Clinic staff provides
centre, where preventive, promotive, curative, comprehensive, intensive mental health
referral and educational services are provided services for children and their families. This
in a package manner to under five includes:
children under one roof ✓ • Assessment – through this process, a
✓ Goal psychologist will work with your child to
• To overall goal of under-five clinic is evaluate their behavior, personality and
to provide comprehensive health care capabilities.
to young children in
a specialized facility.
✓ Goals ✓ Goals
✓ Care in illness ✓ The first goal of child guidance is to help
✓ Growth children learn social skills that will enable them
monitoring to get along with other people. The second aim
✓ Preventive care is to maintain classrooms in which each child
✓ Family planning can feel secure and comfortable
✓ Health education while learning.

✓ A detailed Under 5 Card is maintained for each
child. The card has details about the child’s
weight, health history, immunization details etc.
We weigh and monitor a child’s progress and
give advice where appropriate. Any other
vaccines will be supplied by the patient.
✓ Positive child guidance describes the support
provided in terms of social and emotional
growth for the child . It is a process of guiding
children to develop healthy self- esteem,
respect for themselves and others and skills to
manage an array of potential
stressors

✓ Functions
They were responsible for the immunisation, the
nutrition of the children through monitoring of
the weight curve, advising the mothers on the
✓ Functions
✓ Child Guidance Clinic staff provides
comprehensive, intensive mental health
services for children and their families. This
includes: Assessment – through this process, a
 means to achieve an adequate birth interval, and
the treatment of common conditions
✓ Objectives
✓ Monitor growth and development of the child
until 5 years of age.
✓ Identify factors that may hinder the growth and
development of the child.
✓ Activities and Strategies
✓ Regular height and weight determination/
monitoring until 5 years old. 0-1 year
old=monthly 1 year old and above =quarterly
✓ Recording of immunization, vitamins
supplementation, deworming and feeding.
✓ Provision of IEC materials (ex. Posters, charts,
and toys) that promote and
enhance child’s proper growth and development.
✓ Provision of a safe and learning
– oriented environment for the child.
✓ Monitoring and Evaluation.
CHARACTERISTICS PHENYLKETONURIA
DEFINITION It is a genetic disorder that is
characterised by an inability of the
body to utilize the essential
aminoacid,phenylalanine
SIGNS AND • A musty odour in breath,skin
SYMPTOMS or urine
• Neurological problems
psychologist will work with your child to
evaluate their behavior, personality and
capabilities.
✓ Objectives
✓ Providing help for children with behavioural
problem like pica, bed
✓ wetting,
sleepwalking , speech defects etc.
✓ Providing care & guidance for children with
mental retardation.
✓ Providing care
for children with learning difficulties.
✓ Providing counselling & guidance &
information to parents regarding care
&upbringing of
children.
✓ Activities
✓ Managing behavioural problems.
✓ Managing learning difficulties.
✓ Managing emotional problems
✓ Managing adjustment problems.
✓ Managing developmental problems.
✓ Managing intellectual deficit.
✓ Managing socio legal issues
✓ Activities and Strategies
✓ Regular height and weight determination/
monitoring until 5 years old. 0-1 year
old=monthly 1 year old and above =quarterly
✓ Recording of immunization, vitamins
supplementation, deworming and
feeding.
✓ Provision of IEC materials (ex. Posters,
charts, and toys) that promote and
enhance child’s proper growth and development.
✓ Provision of a safe and learning
– oriented environment for the child.
✓ Monitoring and
Evaluation.
GALACTOSEMIA
Galactosemia is a disorder that
occurs when the body is unable to
breakdown a type of sugar called
galactose that is found in milk
&milk products
• convulsion
• irritability
• poor feeding
 • Skin rashes
• Hyperactivity
RISK FACTORS • Having both parents with a
defective gene that cause PKU
• Being of certain ethnic descent
DIAGNOSIS • screening for PKU involves:
- Determination of phenylalanine a.amniocentesis
level
- The Guthric test as a bacterial
inhibition assay
- Molecular testing
COMPLICATIONS • Irreversible brain damage
• Neurological problems
• Behavioural ,emotional &
social problems
CHILDREN
ANATOMIC & • Newborn have larger and
PHYSIOLOGICAL heavier head compared to his
CHANGES body
• Thinner skin than adult
INTEGUMENTARY • Apocrine sweat gland-small
SYSTEM and non-functional from birth
to preschool years
RESPIRATORY • Respiratory Rate:
SYSTEM 30-60 breaths/ min
• Heart rate:
100-160 beats/min
HEMATOLOGICAL • Newborn RBC are Microcytic
SYSTEM • Lifespan of RBC are 60-90
days
• Blood volume -
85 ml/ kg of Body Weight
URINARY SYSTEM • Infant's kidney are immature
with reduced ability to filter
and concentrate urine
GI SYSTEM • Cardiac sphincter of stomach is
relaxed in infants resulting in
frequent regurgitation and
vomiting during infancy
NEUROLOGICAL • Weight of brain in child is 300-
SYSTEM 500 gm
• poor weight gain
• poor growth
• Learning disabilities
• ovarian failure
• prenatal testing
chorionic villus sampling or cvs
• Newborn screening
• Liver damage or liver
failure
• serious bacterial infections
• shock
• Delayed development
ADULT
• Adults head is not heavier
than body
• Skin is not much thinner
than children
• Apocrine gland are
properly developed in
Axilla, Areola & Genital
area
• Respiratory Rate:
16-20 breaths/min
• Heart Rate:
60-100 beats/min
• Adult RBC are Macrocytic
• Life span of RBC are
100-120 days
• Blood Volume -
60-70 ml/kg of BW
• Kidney's are mature
enough for proper
functioning
• Cardiac sphincter of
stomach is fair Li Titan
adults
• Weight of brain in adult is
1300-1400 gm