DI

FFERENT
IAT
EBET
WEEN
C
HARAC
TERI
STI
CS L
IVEVAC
CINE KI
LLEDVAC
CINE

AGENTUS
ED L
iveat
tendedor
gani
sm Ki
l
ledor
gani
sm

DURAT
IONOFI
MMUNI
TY l
onger S
hor
ter

I
MMUNOGL
OBUL
INSP
RODUC
ED I
gA,
IgG I
gG

EF
FEC
TIVENES
SOFP
ROT
ECT
ION gr
eat
er l
ower

BOOS
TERI
MMUNI
SAT
ION Notr
equ
ired Requ
ired

C
OLDC
HAI
N r
equ
ired Requ
ired

C
OST L
essc
ost c
ost
ly

C
ELLMEDIAT
EIMMUNI
TY y
es No
P
RODUCED

ADJ
UVANT Notr
equ
ired r
equ
ired

ANT
ERI
ORF
ONT
ANEL
LE P
OST
ERI
ORF
ONT
ANEL
LE

AL
SOC
ALL
ED Br
egma L
ambda

L
OCAT
ION F
oundatj u
ncti
onof S
itu
at edatjunc
tionof
s
agit
tal,c
oronaland l
ambdoi dalands agi
ttal
f
rontalsu
tures
. s
utures.

S
HAP
E Broadkit
e/di
amond S
mal
ltr
iangu
lars
hape
shaped

T
YPE S
oftmembr
anef
loor Bonyf
loor

AGEOFC
LOS
URE 1
8mont
hs 6t
o8weeks
 T
UBERC
ULOUSMENI
NGI
TIS BAC
TERI
ALMENI
NGI
TIS

F
EAT
URES

DEF
INI
TION I
tisaf orm ofmeni ngiti
s I nfl
ammati
onofbrainandspi
nalc
ord
charac
ter
izedby t
ypi
cal
l
ycau
sed byaninf
ect
ion
i
nf l
ammat ionoft he
membr anesc ausedby
speci
fi
cbact eri
um knownas
Mycobact
eriu mT u
bercu
losi
s.

C
LINI
CAL  Headac
he  P
aini
nbac
k,mu
scl
esornec
k.
F
EATURES
 Behavi
our
alc
hanges  F
ever
,chi
l
ls,
fat
igu
e,l
ethar
gy.

 F
ever  Nau
sea,vomi
ti
ng.

 S
tif
fnec
k  Bl
otc
hyorr
edl
ashes
.

 Vomi
ti
ng  I
rri
tabi
l
ity
,headac
he,s
tif
fnec
k.

 I
rri
tabi
li
ty,  Bul
gingfontanel
l
e,ment
al
dr
ows i
ness conf
u s
ion.

 S
tupor
,pos
sibl
y
l
eadi
ngtocoma.

DIAGNOS
TIC  Basedoncli
nic
al  Hi
stor
ycol
l
ect
ion
TESTS present
ati
on
 C
SFexami
nat
ion
 Neuroi
maging
char
act
eri
sti
cs.  P
oly
mer
aseC
hai
nReac
tion

 C
SFexami
nat
ion  Rapi
dDi
agnos
ticT
est
s

 HI
Vser
ology  S
erol
ogi
cst
udi
es

 C
ult
ureofbodyf
lui
ds.  Hi
stopat
hol
ogy

 Otherradi
ogr
aphi
c  Ot
herl
abs
tudi
es
st
udies
T
REAT
MENT  Antit
uber
cul
ar  Anti
bioti
cs
tr
eatmentfor12 (c
efotaxi
me,c
eft
riaxone)
weeks
 Ant
iinf
lammat
oryt
her
apy
 S
ter
oidt
her
apy
(Dexamet
has
one)
 S
uppor
tiveand
 Ant
iconvu
lsant
s
s
ymptomat i
cther
apy

C
OMMUNI
CAT
IVEHYDROC
EPHAL
US NONC
OMMUNI
CAT
IVEHYDROC
EPHAL
US

 Obs
tru
cti
oni
nthes
ubar
achnoi
dspac
e.  C
all
edi
nternal
,obst
ruc
tive,non
c
ommunicati
nghydroc
ephalus.

 Obs
tru
cti
onwi
thi
nvent
ric
ulars
yst
em.
 C
ausesposthemorrhage,bacter
ial
meningi
ti
s,mali
gnantmeni ngit
is.

 Doesn’
tpreventt
hevent
ric
lesfr
om  C
aus
esi
ncl
udec
ongeni
talandac
qui
red.
commu ni
cati
ngwitht
hesubarac
hnoi
d
spac
e.
 Theventr
icl
esarenoti
ncommu
nic
ati
on
wit
hs u
barachnoi
dspac
e.

 Oc
cur
swhent
heC
SFf
lowsou
toft
he
ventri
cl
eandi nt
othespi
nalc
analbutnot  Occ
lusi
onu s
ual
l
yoc
cur
sinc
erebr
al
reabsorbednormall
ybythet
iss
ue ac
quiduct
.
surrou
ndingthebrai
nandthespinal
cord.

DI
SEAS
ECHARAC
TERI
STI
CS GL
AUC
OMA C
ATARAC
T

Glau
comai sagrou pof Cat
arac
ti sac onditi
oni n
eyedis
ordersresu
ltin whi
chthel ensoft heey e
Def
ini
ti
on damaget otheopticnerve bec
omec loudyt hatleads
andcausesvis
ionloss. toadecreas edvisi
on.
Pat
hophysi
ologi
cal Incr
easedintr
aocular Accumu l
ati
onofpr ot
einor
mechani
sm pressu
redu et
o yel
lowpi gmentinthelens
accumulat
ionofaqu ou
s thatreducestr
ansmission
humori ntheeye. oflighttothereti
naat
thebac koftheeye.

C
aus
es Oc
ularhy
per
tens
ion Agi
ng

Agi
ng Traumaorradi
ati
on
exposu
re.
Familyhi
stor
yof
glau
coma C
ongeni
tal

F
oll
owi
ngey
esu
rger
y

T
ypes Openangl
egl
auc
oma C
ongeni
talc
atar
act
s

Angl
ecl
osu
regl
auc
oma Nu
clearc
atar
act
s

C
ort
icalc
atar
act
s

Post
eri
orsu
bsc
apu
lar
c
atarac
ts

S
ignsands
ympt
oms Openangl
e–usu
all
y Redu
cedvi
si
on
pai
nles
sasymptomat
ic
Bl
urr
ing
Anglecl
osure-
sudden
ocu
larpain Gl
are

Hal
osar
oundl
i
ght
s Ambl
yopi
a

Hi
ghi
ntr
aoc
ularpr
ess
ure

Redey
e

Dec
reas
edvi
si
on

F
ixedmi
ddi
l
atedpu
pil

Di
agnos
is Hi
stor
ycol
l
ect
ion Hi
stor
ycol
l
ect
ion

Ey
eexami
nat
ion Vi
sualac
qui
tyt
est

Opht
hal
mos
copy S
li
tlampexam

T
onomet
ry Ret
inalexam

Goni
osc
opy

P
eri
met
ry

Ner
vef
ibe
ranal
ysi
s
T
reat
ment Argonl
aser C
atar
acts
urger
y
tr
abecu
lopl
ast
y
[r
emovi ngclou
dedlens
T
rabec
ulec
tomy andr epl
aci
ngitwit
h
arti
fi
c i
all
ens
Med;

P
ros
tagl
andi
nanal
ogs

Betaadr
ener
gicr
ecept
or
agoni
sts

PARAMET
ER MENI
NGOC
ELEE MENI
NGOMYL
ECEL
E

DEF
INI
TION Bir
thdef ectinwhi c
h Fai
lureofcl
osur
eofneu ralt ubeinwhi cha
i
ncompl etec l
osu
r eof cys
ticswel
li
ngoc c
ursovert hes it
eoft he
backboneand spi
naldefectwhic
hc ontainsmeni nges,
membr anesandar ound nerverootsandthes pi
nalc orditsel
f
thespinalcordwhi ch whichhasleftthevertebr alc anal
protru
siont hatincl
udes
themeni ngesands ac
contai
ningC SF

di
agr
am

s
ever
ity Les
scommonandnot Mos
tsever
e
verys
ever
e

I
nvol
vement Onlymeningesar
e Spi
nalcordands
urr
oundi
ngmeni
nges
i
nvolvednotthespi
nal areinvol
ved
cor
d
REGI
ON l
umbos
acralregi
on, 8
5%oc
curi
nlu
mbos
acr
alr
egi
on
t
hor
aci
cregionandsku
ll

P
rot
rus
ion Thati
nclu
desmeninges S
pinalc
ordandmeni
ngespr
otr
udesou
t
andas accont
ainC
SF t
hevertebr
a

GROWT
H DEVEL
OPMENT

 Theincr
easei
nc el
lsi
zeandnumbert
hat  Theprogr
essi
vechangesi
nsize,s
hape
takespl
acedur
ingtheli
fehi
stor
yofan andf u
nct
iondur
ingtheli
feofan
organi
sm. organi
sm.

 Theinc
reas
einsiz
eandmas
sovera  Thet
rans
for
mat i
onofanor
gani
smi
nto
peri
odoftime. amorecomplexf
orm.

 Apar
tofdevel
opment
.  I
ncl
udesgrowth,mor
phogenes
isand
di
ffer
enti
ati
on

 Oc
cur
sator
gani
zat
ionall
evel
.
 Oc
cur
satc
ell
ul
arl
evel
.
 C
ont
inu
est
hrou
ghou
tli
fe
 S
topsatmat
urat
ion.
 As
ubj
ect
ivei
nter
pret
ati
on.
 C
anbemeas
ureddi
rec
tly
.
 Qu
ant
itat
iveandqu
ali
tat
ive
 Qu
ant
itat
ive.

C
HARAC
TERI
STI
CS APL
AST
ICANEMI
A MEGAL
OBL
AST
ICANEMI
A

De
fini
ti
on Itisat ypeofanemi a Megaloblas
ticanemiaisaRBC
causet hereduct
ioni nthe cel
ldisor
derdu etothe
amou ntofhemat opoi
etic i
nhibi
tionofDNAs ynt
hes
is
tis
s uecausi
nginabi l
it
yt o duri
nger yt
hropioes
is.
produ cemat u
rec ell
sfor
dischargeintoblood
stream.

C
aus
es  I
diopat
hic Vi
taminB12andC
obal
ami
n
defi
ci
ency
 S
ec ondary:
i
diosyncrati
cdrug, F ol
i
cac
iddefi
ci
ency
c
hemi calexpos
ur e,
aandbdefi
ci
ency
 i
nfec
tiou
shepat
iti
s

 Congeni
tal:fanconi
anemia,inheri
ted
thrombocytopenia

T
ypes C
ongeni
talapl
ast
icanemi
a 1
)Fol
ate-
Def
ici
enc
yAnemi
a.

Ac
qui
redapl
ast
icanemi
a  2
)Per
nic
iou
sAnemi
a.

 3
)Megal
obl
ast
icAnemi
aand
Vi
tami
nB1
2.

pat
hophy
siol
ogy Immu nemediated  Theunder l
yi
ngf eaturein
suppr
essionofmar r
ow megal oblast
icanemi aisa bl
ock
el
ement sledt
o i
nDNAs ynthesi
si nrapidl
y
divi
dingc el
ls.Thisoccur
sdueto
act
ivati
onofC y
totoxi
cT i
nabili
tyt omet hy l
ate
cel
l
sinbloodandmar r
ow deoxyuridyl
atet othymidyl
atein
rel
easegammaI FNand theDNAs ynthesispathway.
TFNledtoinhi
bitearl
yand
l
ateprogenit
orcell
s.

C
li
nic
alf
eat
ures P
ers
ist
antpal
l
or Anemicsymptom;weakness,
pal
pit
ati
on,fati
gue,j
aundi
ce.
P
ronet
oinf
ect
ions
Neu
rol
ogi
cals
ympt
oms
Hemat
amei
si
s,hemat
urea
Gastroi
ntes
tinals
ymptoms:
L
euc
openi
a diar
rheal
ossofappeti
te,r
ed
t
hromboc
ytopeni
a soresmoothtongue

Management Redc
ellt
rans
fus
ion I
ncreaseintakeofvi tB12.1mg
ofIMHy droxycobal
ami ndaily
Bonemarrow unt
ilreti
cul
ocyterecoveryafter
tr
anspl
ant
ati
on whi
c hthedosingwass pacedto
I
mmu
nes
uppr
ess
ion onceaweek.•T hediseasecan
befataliflef
tu ntr
eated.
T
reatmentforprevent
i
nfec
tionandhemor rhage.

C
HARAC
TERI
STI
CS OMP
HAL
OCEL
E GAS
RTROS
CHI
SI
S

HERNI
ATEDVI
SCERA Bowel±l
i
ver Bowelonl
y

S
AC P
res
ent Abs
ent
AS
SOC
IAT
EDANOMAL
IES C
ommon(
50%) Unc
ommon(
˂10%)

L
OCAT
IONOFDEF
ECT Umbi
l
icu
s Ri
ghtofu
mbi
l
icu
s

MODEOFDEL
IVERY Vagi
nal
/ces
arean Vagi
nal

S
URGI
CALMANAGEMENT Nonu
rgent Ur
gent

C
HARAC
TERI
STI
CS C
ONVUL
SIONS EP
ILEP
SY

DEF
INI
TION As u
ddenvi ol
entirregul
ar I
tisadisorderc harac
teri
zedby
movementoft hebodyc aused 2ormor eu nprovokedseizu
res
bymas s
iveelec
tric
aldisc
harges occ
urri
ngmor et han24hours
i
nagr oupofner vecel
lsin apartbeyondneonat alperi
od.
brai
nleadst ochangei nmental
acti
vit
iesanbehavi or.

C
LAS
SIF
ICAT
ION Gener
ali
zed: Gener
ali
zedepi
l
eps
ies:

 Gr
andmal  Abs
enc
esei
zur
e

 P
eti
tmal  My
ocl
oni
csei
zur
e

P
art
ial:  T
oni
csei
zur
e

 S
impl
e  T
oni
ccl
oni
csei
zur
e

 c
ompl
ex  At
oni
csei
zur
e

F
ocalepi
l
eps
ies:

 S
impl
epar
tial

 C
ompl
expar
tial

 Part
ials
eiz
urewit
h
sec
ondary
general
i
zati
on.

C
AUS
ES  Hi
ghf
ever  I
diopat
hic

 I
nfec
tion  S
econdar
y

 P
ois
oni
ng  C
erebr
alt
umor
s

 Headi
nju
ry  Neur
odegene
rat
ive
di
sorder
s
 Epi
l
eps
y
 Neur
ocut
aneou
s
 S
troke sy
ndrome
  Hy
poxi
a

C
LINI
CALMANI
FES
TAT
IONS  T
wit
chi
ngofar
m orl
eg  I
nfant
il
espas
m

 Au
tomat
ion  Benignneonat
al
convul
si
on
 C
onf
usi
on
 Acqui
redepi
l
ept
ic
 F
ever aphasi
a
 Rect
altemper
atu
re  Dr
avets
yndr
ome.
˃102
˚F

MANAGEMENT  Ant
iepi
l
ept
ics  Ket
ogeni
cdi
et

 S
edat
ives  Nerves
timu
lat
ion
ther
apy
 F
lui
ds
 Rati
onalc
ombi
nat
ion
 Oxy
gent
her
apy ther
apy
 Ai
rwaymanagement  Monot
her
apy

HODGKI
N’SL
YMP
HOMA NONHODGKI
N’SL
YMP
HOMA

L
ymphmalignanc
yofpr
oli
fer
ati
ngger
minal Monoc
lonalpr
oli
fer
ati
onofBorTl
ymphoc
ytes
c
ent
erc
ell
.

EBV,pr
edomi
nalagedi
str
ibu
tionwi
tht
hef
irs
t EBV,Hi
V
peakat

2
0-3
0year
s.

Reed-S
ter
nber
gcel
l
spr
esent Reed–S
ter
nber
gcel
l
sabs
ent

C
ont
agi
ousl
ymphnodes
pread Nonc
ont
agi
ousl
ymphnodes
pread.

T
reat
ment: T
reat
ment:

C
hemot
her
apy C
hemot
her
apy

Adr
imy
cin Adr
imy
cin

Bl
eomy
cin C
ytoxon

Vi
ncr
ist
ine Onc
ori
n

Dac
arbaxi
ne P
redni
sone.

L
OBARP
NEUMONI
A BRONC
HOP
NEUMONI
A
DEF
INI
TION I
tisaf or
m ofpneu
moni athat I
tisaf orm ofpneu
monia
aff
ectsoneormorelobesof c haract
eriz
edbyinf
lammati
on
l
ungs. oflungsarisi
ngi
nbronc
hior
bronchi
oles.

L
OCAT
ION L
argearea,evenwhol
elobe Of
tenbi
l
ater
al
i
nvol
vement
L
owerl
obes

ROUT
EOFI
NFEC
TION Bot
hal
veol
iandbr
onc
hiol
es Spreadsf
rom br
onc
hiol
est
o
nearbyal
veol
i

S
PREADOFI
NFEC
TION Wholelobebec
omes C
ons
oli
dat
ioni
spat
chy
c
onsoli
dated

S
USC
EPT
IBL
EGROUP Mi
ddl
eage2
0-5
0 Ext
remesofage

P
rimar
y,i
nheal
thypeopl
e S
econdar
y,i
nsi
ckpeopl
e

Mal
esc
ommon Bot
hgender
s

C
AUS
ATI
VEORGANI
SM Oft
encaus
edbypneu
moc
occ
us Dependantonci
rcu
ms tances
orkl
ebs
iel
l
a predi
sposi
ngtoinfec
tion

ANAT
OMI
CBOUNDARI
ES Li
mi t
edbyanat
omi
c Notli
mit
edbyabnat
omi
c
boundar
ies bou
ndari
es

NODUL
ES Us
ual
l
yabs
ent C
ent
ril
obu
larnodu
les

DOWNS
YNDROME T
URNERS
YNDROME

DEF
INI
TION I
tisagenet i
cdisordercaused Condit
ionthataff
ectsonl
y
whenabnor malcelldi
visi
on female,whenoneofX
resu
ltsinextr
agenet i
c chromosomei smiss
ingor
mat eri
alfr
om chromos ome parti
all
ymissi
ng.
21.

RI
SKF
ACT
ORS  Advanc
ingmat
ernal  L
ossoralt
ernat
ivesofX
age. c
hromosomeoccur
r
andomly
 Carri
erofgeneti
c
transl
ocati
onfor
downs yndrome.

 Havi
nghadonechi
l
d
wit
hdownsyndr
ome

S
YMP
TOMS  F
lat
tenedf
ace  Wi
deorwebl
i
kenec
k
  S
mal
lhead  S
wel
l
ingonhandsorf
eet

 P
rot
rudi
ngt
ongu
e  S
lowedgr
owt
h

 P
oormu
scl
etone  C
ardi
acdef
ect
s

 S
hor
tnec
k  S
hor
tfi
ngerandt
oes

C
OMP
LIC
ATI
ONS  Hear
tdef
ect
s  Hi
ghBP

 GIdef
ect
s  Hear
ingl
oss

 I
mmu
nedi
sor
der  Vi
si
onpr
obl
ems

 S
leepapnea  Ki
dneypr
obl
ems

 obes
ity  Hear
tpr
obl
ems

T
REAT
MENT T
her
api
es: Hor
monet
her
apy:

S
peec
hther
apy Gr
owt
hhor
monet
her
apy

Oc
cupat
ionalt
her
apy Es
trogent
her
apy

P
hys
icalt
her
apy

S
elfc
are

HYP
OSP
ADI
AS EP
ISP
ADI
AS

DEF
INI
TION Hypospadi
asisref
erstothe Epi
spadias
isisacongeni
tal
uret
hralopeningthati
sonthe malformationinwhic
hthe
ventrals
urfaceofthepeni
l
e openi
ngoft heuret
hraisonthe
shaft dorsu
m oft hepeni
s.

I
NCI
DENC
E Occu
rsi
nupt
o4in1
000 Occ
ursin1i
n1,
17,
000newbor
n
newbor
nboy
s. boysand1i
n484,
000newbor
n
gi
rl
s.

C
AUS
ES  P
res
entatbi
rth  Unknown

 Defec
tinandr
ogen  Rel
atedtoi
mproper
sti
mulat
ionof devel
opmentofpubi
c
devel
opi
ngpenis bone

 Def
ici
entandr
ogen  F
ail
ureofabdomi
naland
 pr
odu c
tionbyt
est
esand pel
vicfissi
oninthef
irs
t
pl
acenta mont hsof
embr yogenes
is.

T
YPES Ant
eri
orhy
pos
padi
as Gl
anu
larepi
spadi
as

P
ost
eri
orhy
pos
padi
as P
eni
l
eepi
spadi
as

Mi
ddl
ehy
pos
padi
as P
enopu
bicepi
spadi
as

S
YMP
TOMS P
hys
icaldef
ormi
tyofpeni
s Bac
kwardf
lowofu
rinet
o
ki
dney
Abnor
malu
rinar
yst
ream
Ur
inar
yinc
ont
inenc
e
S
exu
aldy
sfu
nct
ion
UT
I

DI
AGNOS
TICMEAS
URES P
renat
alu
ltr
asou
nd P
renat
aldi
agnos
is

Phys
icalexami
nat
ionof Bl
oodt
est
newborn
I
ntr
avenou
spy
elogr
am
Exc
ret
oryu
rogr
am

T
REAT
MENT Adj
uvanthor
monalt
her
apy Maxi
miz
epeni
l
elengt
h

C
irc
umc
isi
ons
hou
ldbeavoi
ded Mi
tchel
l
’st
echni
que

BRONC
HIT
IS BRONC
HIOL
ITI
S

DEF
INI
TION I
tisaf ebr
il
eil
l
nessc
harac
teri
zed Itisas er
iou
sil
lnesschar
acter
ized
bycoughandwheezi
ng.I
tinvol
ves byinf
lammat i
onofbr onchi
oles,
i
nf l
ammat i
onofoneormor e cau
seseveredyspnea.
bronchi
.

C
AUS
ES Rhi
novi
rus Adenovi
rus

Adenovi
rus I
nfl
uenz
avi
rus

C
hemi
calagent
s: S
trept
ococ
cushemol
yti
cus

Du
st,al
l
ergens
,st
rongf
umes
.

C
LINI
CALF
EAT
URES Ru
nnynos
e Dy
spnea

Mal
ais
e F
ever

C
hil
l
s C
yanos
is

F
ever Nas
alf
lar
ing
 Wheez
ing Ret
rac
tions

S
oret
hroat Wheez
ing

DI
AGNOS
TICEVAL
UAT
ION Hist
orycol
lec
tion&phy
sic
al Hist
orycol
lec
tion&phy
sic
al
examinati
on examinati
on

X-
ray X-
ray

C
hes
tau
scu
ltat
ion

MANAGEMENT Ant
ibi
oti
cs Ant
ibi
oti
cs

C
oughexpec
tor
ant
s Oxy
genadmi
nis
trat
ion

Ant
ipy
ret
ics I
Vfl
ui
ds

S
team i
nhal
ati
on P
revent
ionofdehy
drat
ion

MENI
NGI
TIS ENC
EPHAL
ITI
S

Meni
ngi
ti
sistheinf
lammationofprot
ecti
ve Iti
sanacut
einf
lammat
ionoft
hebr
ain
l
ayer
softis
sue/membranescover
ingbrai
n. parenc
hyma.

C
aus
edbybac
ter
ia,vi
rusandf
ungi C
ommonl
ycau
sedbyvi
ralagent
s

C
anexi
stonl
yasas
ingl
efor
m C
anoc
curaspr
imar
yors
econdar
yty
pes

Sy
mpt omsi nc
ludesuddenfever
,sever
ehead Symptomsincl
udemoder ate–sever
ef ever
,
ache,nausea,vomi ti
ng,doubl
evisi
on, sei
zur
es,behavi
oralchanges,c
onfusi
on,
drowsines
s ,photophobiaandsti
ffneck dis
ori
entat
ionandr el
atedneurol
ogi
cs i
gns.

Di
agnosedbyr
out
inebl
oodexami
nat
ionsand Mi
ghtneedneu
roi
magi
ngt
echni
ques
cu
ltu
res
.

Wil
lbetreat
edwithampicil
li
ncombi
nedwi
th Wi
l
lbet
reat
edwi
thI
VAc
ycl
ovi
rfor1
0day
s
aminogl
ycos
ideorcephal
ospori
n.

AT
RIALS
EPT
ALDEF
ECT VENT
RIC
ULAR S
EPT
ALDEF
ECT

DEF
INI
TION Anopeni ngint heatri
al Anopeningi ntheventri
cul
ar
septum.Itall
owsoxy genated septum.All
owsoxy genated
bloodtopas sf rom t
heleft bloodtopas sfrom thel
eft
atri
um,t hroughopeninginthe ventri
cl
es,throughtheopening
septum andt henmi xwith i
nt heseptum andthenmi x
deoxygenatedbl oodinri
ght withdeoxygenatedbloodin
 at
riu
m r
ightvent
ric
le.

C
LINI
CALMANI
FES
TAT
IONS T
achy
pnea Exer
tionaldy
spnea

T
achy
car
dia Heavyandc
onges
tedbr
eat
hing

S
hor
tnes
sofbr
eat
h Exc
ess
ives
weat
ing

Mu
rmu
r

DI
AGNOS
TICEVAL
UAT
ION C
hes
tXr
ay Hi
stor
ycol
l
ect
ion

EC
G P
hys
icalexami
nat
ion

Ec
hoc
ardi
ogr
aphy EC
G,Ec
hoc
ardi
ogr
aphy

MANAGEMENT Exer
cis
eres
tri
cti
on Di
goxi
n

Di
uret
ics Di
uret
ics

Di
gox
in

P
HYS
IOL
OGI
CALJ
AUNDI
CE P
ATHOL
OGI
CALJ
AUNDI
CE

ONS
ET Mor
ethan2
4hou
rs L
esst
han2
4hou
rs

DURAT
ION T
erm :˂2weeks T
erm :˃2weeks

P
ret
erm :˂3weeks P
ret
erm :˃3weeks

S
ERUMBI
LIRUBIN Rai
se˂0.
2mg/dL Rai
se˃0.
2mg/dL
C
ONCENT
RAT ION

T
SB ˂1
5mg/dL ˃1
5mg/dL

I
NVOLVEMENTOFP
ALMS& No Yes
S
OLES

S
IGNSOFAC
UTEBI
LI
RUBI
N No Yes

DI
REC
TBI
LI
RUBI
N ˂2mg/dL Mor
ethan2mg/dL

C
LINI
CAL
LY Looksnor
mal,notanemic,not Looksabnor
mal,anemi
c,si
ck
si
ck andabnormalc
olorofu
rine
andstool
Normaluri
neandstoolc
olor

P
HYS
ICAL
LYC
HAL
LENGED MENT
ALL
YCHAL
LENGED

DEF
INI
TION I
tme
anss
omepar
toft
he Ment
all
ychal
l
engedmeans
 pers
on’sbodydoesnot somepartofpers
on’
smi
nd
func
tion. doesnotfu
nct
ion.

EXAMP
LE P
oli
omy
eli
ti
s Ment
alr
etar
dat
ion

C
erebr
alpal
sy

C
ongeni
taldef
ormi
ti
esi
nli
mbs

Ac
cide
nts

S
pinalc
ordi
nju
ries

T
REAT
MENT Bas
edondi
seas
econdi
ti
ons P
ropermedi
cat
ion

P
hys
iot
her
apy C
ouns
eli
ng

Ot
hert
her
api
es Rehabi
l
itat
ion

medi
cat
ions

C
APUTS
UCC
IDANEUM C
EPHALHEMAT
OMA

I
NCI
DENC
E F
requ
ent 4t
o25i
n1000del
i
ver
y

BI
RTHHI
STORY Ver
texdel
iver
y,vac
cum For
cepsdel
i
very
,di f
ficu
lt
ext
ract
ion del
i
very,morefrequentin
males

L
OCAT
ION Apoi
ntofcont
actc
anext
ent Usual
l
yoverpar
ietalbone,
ac
ros
ssut
ures doesnotcr
osssut
u r
es

S
IGNS&S
YMP
TOMS Usu
all
ynoothersympt
oms
, Usu
all
ynoothersymptoms,
res
olvesi
nsever
alday
s sku
llf
rac
tur
e,severebl
oodl
oss

VOL
UMEOFBL
OODL
OSS Mi
nimal Rar
elys
ever
e

C
HARAC
TERI
STI
CS Vaguel
ydemar c
ated,pi
tti
ng Di
sti
nctmargi
ns,i
nit
ial
l
yfi
rm,
edemat hats
hiftwit
hgravit
y moreflu
ctu
antaft
er48hour
s

P
ROGNOS
IS Exc
ell
ent Res
olvei
n2weekt
o6mont
hs

C
HARAC
TERT
ICS T
RUS
T MI
STRUS
T
 *Thecondit
ionand *Lackoft r
ustor
resu
lti
ngobli
gation confi
dencearis
ing
ofhaving from sus
pici
on.
Def
ini
ti
on confi
denc
epl ac
edin
one. *Tobesuspi
ci
ousor
dou
btf
ul.
*Oneinwhic
h
confi
denc
eis
plac
ed.

I
fc hi
l
dsucces
sfu
ll
y Senseofmi st
rus
tin
devel
optrust
,he chi
ldrenmay
F
eat
ures feel
ssec
ure. percei
vet heworld
i
su npredict
ableand
i
ncons i
stent.

Exampl
e Abbi etru
stSusan, Abbi
emi str
u s
t
becau s
eS u
sanhas Su
san,because
nevert ol
dany one, Su
santoldever y
one
abou tAbbie'
s Abbi
e'ssecret.
sec
r ets.

C
HARAC
TERI
STI
CS C
OMP
LET
EFRAC
TURE GREENS
TIC
KFRAC
TURE

Completefract
uresare Afrac
tureinwhi
choneside
fract
ureswheret heparts ofabonei sbrokenwhi
lethe
Def
ini
ti
on ofthebonet hathavebeen otherisbent(li
keagreen
fract
uredarecompl et
ely s
tic
k)
separatedf
r om eachother
.

I
nci
denc
es Atanyage. Mostoftendur
ingi
nfancy
andchi
ldhoodwhenbones
aresof
t.

*P
ain *P
ain
*L
ossoff
unc
tion *Br
uis
ing
S
ympt
oms *Def
ormi
ty *T
ender
nes
s
*
Shor
teni
ng *S
wel
l
ing
*C
repi
tus *Def
ormi
ty
*S
wel
l
inganddi
scol
orat
ion

T
reat
ment *Redu
cti
on *I
mmobi
l
izi
ng t
hebone
 *I
nternalandext
ernal wi
thac
astors
pli
nt.
Fi
xat
ion
*Redu
cti
on
*I
mmobi
l
izat
ion
*Int
ernalandext
ernal
*S
pli
tti
ngand T
rac
tion fi
xati
on

C
HARAC
TERI
STI
CS KWAS
HIORKOR MARAS
MUS

C
aus
e T
hisdi
seas
eiscaus
eddueto Thisdis
easeiscauseddu
eto
s
everedefi
ci
encyofpr
otei
n. severedefic
ienc
yofall
nutri
ents,pri
mar i
l
y
carbohydrat
es.

C
alor
iei
ntake Nor
mal I
nadequ
ate

P
eri
pher
aledema P
res
ent Abs
ent

Appet
ite P
oorappet
ite Vor
aci
ousappet
ite

F
att
yli
ver C
ommon Unc
ommon

S
kinc
hanges Dermatosi
s,f
lakypai
nt Ski
nisdryandwr
inkl
edbu
tno
appearanc
e der
mat i
ti
s.
ofskin

S
ubc
utaneou
s S
ubc
utaneou
sfati
spr
eser
ved S
ubc
utaneou
sfati
sabs
ent

f
at

Hai
rchanges C
ommon Abs
ent

P
rognos
is Wor
sepr
ognos
is Bet
terpr
ognos
is

F
EAT
URES RES
PIRAT
ORYDI
STRES
SSYNDROME MEC
ONI
UMAS
PIRAT
IONS
YNDROME

(
RDS
) (
MAS
)
 Abr eat
hingdis
orderi nnewbor ns Meconium as pirat i
ons yndromei s
caused by i mmat ure l ungs.t r
ou bl
e br eathing ( respiratory
Ne onatal respirat
ory di s
tress di
s t
ress)i n a newbor n who has
Def
ini
ton s
i yndr ome ( NRDS ) i s mor e breathed ( aspirated) a dar k
common i n pr emat ur
e babi es green,st er
ilefec almat eri
alc al
led
bor ns i
x weeksormor e before mec oniu
mi ntot helungsbef oreor
theirduedates.Itusual
lydevelops aroundt het i
meofbi rth.
withint he fi
rst2 4 hours after
birth.

Themos tc ommonc au seofARDS Mec oni

um as pi
rati
on happens
i
ss epsis,as eri
ou sandwi despread whenababyi sstr
essedandgas ps
i
nf ec
tion of t he bl oods tream. whi l
es t
il
lint hewomb,ors oon
Et
iol
ogy I
nhalat i
onof har mf uls
ubs tances. aft
erdeliverywhen taki
ngt hose
Breathing high c oncentrationsof f i
rst breaths of ai r
. When
smoke or c hemi calf umes c an gas pi
ng, a baby may i nhale
resul
ti n ARDS ,as c an inhal i
ng amni oti
cf l
ui
dandanymec oni u
m
(aspir
at i
ng) vomi t or near -i nit.
drowni ngepisodes .

Res
pir
atory:respi
rat
ory di
str
ess
,C yanosi
s.
fas
t br eat
hing, short
ness of
bre
ath,orrapidbr
eathi
ng. End-expi
rat
orygr
unt
ing.

Whol e body :low oxy gen int he Alar( nas al

)f l
ari
ng.

Cli
nic
al bodyorf ever.Alsocommon:bl ueInt ercostalretrac
tions.
f
eatures skin f r
om poor c i
rcu
lation,
coughing, high c ar
bon di oxide Tachy pnea.
l
e vel
si nblood,mu scl
eweaknes s
,
Bar relchest(incr
eased
oror gandy sfunc
tion.
ant eropos t
eri
ordiamet er
)duet
o
thepr esenc eofairtrappi
ng.

Ausc
ult
atedral
esandr
honc
hi(
in
somec as
es).
 TreatmentofARDSi ssupport
ive, oxy gen therapy to make s u
re
i
nc l
udi
ng mec hanicalvent i
lat
ion, ther eis enough oxygen int he
preventi
on of s tressulcer
s and bl ood.
T
r ment venou
eat s t hromboembol i
sm, and
theu seofa r adi
antwar mert o
nutri
ti
onals upport.
help y our baby mai nt
ain body
Mos t pati
ent s wi th ARDS need t emper atur
e.
sedati
on, intubati
on, and
ventil
ati
on whi l
et he underl
ying antibioti
cssuchasampi ci
l
li
n and
i
njuryistreated. gent amici
nt opreventortreatan
i
nf ecti
on.

the u se of a vent i
l
ator (
a
breathi
ng machine)t
o hel
pyour
i
nf antbreat
he.

DI
PHT
HERI
A P
ERT
USS
IS

DEF
INI
TION I
tisanac u
teinfecti
ousdisease I
tisahighl
ycont
agiou
sdisease
t
hattypic
all
ys t
rikestheupper aff
ect
ingtheres
pir
atoryt
r ac
t
r
espi
ratorytractincl
udi
ngt hr
oat

C
AUS
EDBY C
ory
nebac
ter
ium di
pht
her
ia Bor
det
ell
aper
tus
sis

C
LINI
CALF
EAT
URES  Ons
etwi
thf
ever  C
yanos
is

 Mal
ais
e  Longinspi
rator
yeff
ort
accompaniedbyahigh
 Headac
he pit
ched“whoop”.
 Weaknes
s  Vomi
ti
ngandexhau
sti
on
 Re
spi
rat
orydi
str
ess  Anor
exi
a
 C
yanos
is  Dehy
drat
ion
 wheez
ing  Di
ffi
cul
tys
lee
ping

 Ot
iti
smedi
a

DI
AGNOS
TICS
TUDI
ES  Gram st
ainort
hroat  Hi
stor
yoft y
pic
als
igns
cu
ltu
re andsymptomsof
di
sease.
  El
eki
mmu
nodi
ffu
siont
est  P
hys
icalexami
nat
ion

 St
eri
lec
ott
ont
ipped  Labtestsi
ncl
ude
appl
i
cat
ors nasophary
ngealswabs
.

 EC
G  Bl
oodt
est

 T
hroatorl
esi
onc
ult
ure

MEDI
CALMANAGEMENT Er
ythr
omy
cin Adequ
atenu
tri
ti
on,r
est

Ant
itoxi
n Oxy
genat
ion

Ant
ibi
oti
cs Res
pir
ator
yther
apy

S
uppor
tivet
reat
ment Mec
hani
calvent
il
ati
on

Ant
ipy
ret
ics Ant
imi
crobi
alt
her
apy

Vac
cines

NURS
INGMANAGEMENT  Dr
opl
eti
sol
ati
on  P
rovideadequ
atebed
r
est.
 Encou
rageflui
d,s
mal
l
fre
quentfeeds  Enc
our
agef
lui
dint
ake

 Observesignsofai
rway  Moni
tors i
gnsofai
rway
obs
t r
ucti
on obs
truc
tion

 Bedr
est
,ment
alr
est  T
reats ec
ondar
y
i
nfec
tion

WEANI
NG ART
IFI
CIALF
EEDI
NG

DEF
INI
TION I
tist
hepr oc
essofgivi
nginf
ant
s Motherwhoar eunableto
ot
herfoodsandli
qui
dsalongwi
th breastf
eedorwhodec idenotto
br
eastmilkaft
ertheageof6 breastfeed,i
nfantformulai
s
months. goodalternat
ive.

EXAMP
LES L
iqu
ids
-sou
pofveget
abl
es C
owmi
l
k

S
emi
sol
i
ds–mas
hedpot
ato Bu
ffal
omi
l
k

S
oli
ds–c
ookedr
ice C
ommer
cial
l
yavai
l
abl
edr
iedmi
l
k

T
YPES C
hil
d-l
edweani
ng Bot
tlef
eedi
ng

Mot
her
-ledweani
ng C
upf
eedi
ng

Kat
oriands
poonf
eedi
ng
 Gas
tri
cfeedi
ng

ADVANT
AGES  P
reventmal
nut
rit
ion  Goodf
orwor
kingmot
her
s

 P
romot
esgr
owt
h  P
rovi
deadequ
atenu
tri
ti
on

DI
SADVANT
AGES  Di
arr
hea  Overf
eedi
ng

 Defi
ci
enc
yofprotei
n,  Gas
troent
eri
ti
s
vi
tamins
,cal
ori
es

P
YLORI
CST
ENOS
IS I
NTES
TINALOBS
TRUC
TION

DEF
INI
TION I
tisthenar r
owing(stenosi
s)of I
tisapartialorc
ompl eteblockageof
theopeningfrom s
tomac htothe thebowelthatpreventsthecontents
fir
stpartofs mal
li
ntesti
neknown oftheint
estinef
r om passi
ngt hrou
gh.
asduodenum.

C
AUS
ES  Unknown  I
ntes
tinaladhes
ions

 Genet
ic&envi
ronment
al  Bandsoffibrou
stis
suei
n
fac
tors abdominalcavi
ty

 Her
nias

 C
olonc
anc
er

S
YMP
TOMS Vomi
ti
ng C
rampyabdomi
nalpai
n

P
ers
ist
enthu
nger L
ossofappet
ite

Dehy
drat
ion C
ons
tipat
ion

C
hangei
nbowelmovement
s Ver
ylou
dcr
ying

DI
AGNOS
TICS
TUDI
ES Bl
oodt
est Bl
oodt
est

Xr
ay Xr
ays

C
Tsc
an C
Tsc
ans

Abdomi
nalUS
G C
olonos
copy

Bar
iums
wal
l
ow Enemawi
thc
ont
ras
t

MANAGEMENT py
lor
omy
otomy T
reat
ingi
ntu
ssu
scept
ions

T
reat
mentf
orpar
tialobs
tru
cti
on

T
reat
mentf
orc
ompl
eteobs
tru
cti
on
 T
reat
mentf
orps
eudoobs
tru
cti
on

C
OMP
LIC
ATI
ONS F
ail
uret
ogr
owanddevel
op T
iss
uedeat
h

Dehy
drat
ion I
nfec
tion

S
tomac
hir
rit
ati
on

J
aundi
ce(
rar
ely
)

T
URNERS
YNDROME KL
INEF
ELT
ERS
YNDROME

DEF
INI
TION T
hiss y
ndromeisc
ausedbyt
he Thissyndromeisc
ausedbyt he
l
ackofs exc
hromosome(XO presenceofanextr
as ex
i
nsteadofXX) chromos ome.
(XXYinsteadof
XY).

OC
CURRENC
E 1i
n25
00phenot
ypi
cfemal
es 1i
n11
00phenot
ypi
cmal
es

S
YMP
TOMS L
ymphedema Enl
argedbr
eas
ts

Under
wei
ght Undevel
opedpeni
sandt
est
es

S
wel
l
ingort
hic
knes
sofnec
k

GONADALS
EX Abs
ent Ar
epr
esentandar
eat
rophi
ed

P
HENOT
YPE Under
devel
opedbr
eas
t Presenceofpeni
s,vas
deferensandseminalves
icl
es
Abs
enc
eofmens
tru
alc
ycl
es butar ei
nact
ive
P
resenceofvagi
na,vu
lvaand
u
ter
u s.

T
REAT
MENT Noc
ure F
ert
il
it
ytr
eat
ment

Repl
acementt
her
apy C
ouns
eli
ng

Est
rogenandgr
owt
h Removalofexc
ess
ivebr
eas
t
hormones ti
ssu
e

Hor
monalr
epl
acementt
her
apy

Supportandedu
cat
ional
evaluat
ion.

C
RIT
ERI
A NEGAT
IVI
SM S
IBL
INGRI
VAL
RY
DEF
INI
TION Negati
vis
misdefi
nedasdoi
ngthe Si
bli
ngrival
ryisdefi
nedasthe
oppos
iteofwhatother
swant,
is competi
tionoranimosi
ty
normalfort
oddl
ers betweenbrother
sands i
ster
s

C
AUS
ES T
hec
hil
d'sdes
iref
ori
ndependenc
e J
eal
ous
y

f
eel
i
ngsoff
rus
trat
ionandanger when t
wos
ibl
i
ngsar
ecl
osei
n
age
T
heexc
iti
ngandf
right
eni
ng
compet
iti
onovers
imi
l
ari
nter
est
andgoal
s

S
TRATEGI
ESFOR Redi
rec
tthec
hil
d Res
pec
teac
hchi
l
dasu
niqu
e
P
REVENTI
ON
Enc
our
aget
alki
ng Beani
mpar
tialmedi
ator

Gi
vingc
hoi
ces s
chedu
les
pec
ialt
imewi
theac
h
c
hil
d

EXAMP
LE S
ayi
ngNo! F
ight
ingf
ort
oys

Refus
ingtodoany
thi
ng,
youwant
them to

EMP
HYS
EMA EMP
YEMA

DEF
INI
TION Chr
onicprogres
s i
vel
ungdiseas
e • Anempy
emai sacol
l
ecti
on
whereti
ssuessuppor
tingl
ungsare ofpu
swit
hinabodycavi
ty
dest
royed

C
AUS
ES • S
moki
ng • P
neu
moni
a

• Ai
rpol
l
uti
on • Ru
ptu
reofl
ungabs
ces
s

• Her
edi
tar
yfac
tor
s • Rupt
ureofs
ubphr
eni
c
absc
ess
• Mal
egender
• T
b
• As
thma
• Se
c ondaryi
nfec
tionduri
ng
• Al
l
ergi
es aspirat
ionofpl
eu r
alf
lui
d

S
YMP
TOMS • S
ever
edy
spnea • F
ever

DI
AGNOS
TICS
TUDI
ES • Exami
ningpul
monar
yfu
nct
ion • Labinvest
igat
ion:c
bc,
byspi
rometr
y bloodcu
ltu
re,ser
umL DH
 • Radi
ogr
aphi
cst
udi
es

MANAGEMENT • C
ort
icos
ter
oids • C
efu
roxi
me

• Met
roni
daz
ole
• P
osi
ti
oni
ng
• Benz
ylpeni
ci
ll
i
n

• O2
O2l
ungt
rans
plant
ati
on • c
ipr
ofl
oxac
in

• Amoxy
cil
l
in

• C
li
ndamy
cin

UNDERF I
VEC LINI
C CHILDGUI DANC ECLI
NIC
 Under - f ivec linic•Underf i
vecli
nicisa  Chil
dGu idanc eC l
i
ni cstaffprovi
des
centre, wher e pr event i
ve, promot i
ve, compr ehens ive,intens i
vement alhealt
h
curati
ve,r ef erralandedu cat
ionalservi
ces servicesf orchil
dr enandt heirfami l
i
es.
arepr ovided i n a pac kagemanner Thisinc l
udes :
to u nderf ivec hil
drenunderoner oof  •Ass es s
ment–t hr oughthi
sproc ess
,a
 Goal psychol ogi s
twi l
lwor kwithyourchil
dt o
•Toover allgoalofu nder-five c
lini
cis evaluat et heirbehavi or,per
sonalityand
t
o providec ompr ehensivehealt
h car e capabi l
ities.
toy oungc hi
ldrenin
a specializedf aci
li
ty.
 Goals  Goal
s
 Carei
nill
nes
s  Thef
irs
tgoalofc
hil
dgu
idanc
eist
ohel
p
 Growth chil
drenl ear ns ocials
ki l
lsthatwi l
lenable
moni tor i
ng them t ogetal ongwi t hot herpeopl e.The
 Prevent ivec are secondai mi st omai nt ainc l
ass r
oomsi n
 Fami l
ypl anning whi c
heac hc hil
dc anf eelsec u
r eand
 Healthedu cati
on comf or t
abl e
whi l
elear ning.
 Adet ailedUnder5C ardismai ntainedf or  P ositi
vec hi l
dgu idancedes cri
best he
eachc hild.T hecardhasdetail
sabou tthe suppor tpr ovidedi nter msofs ocialand
chil
d’s emot ional
weight ,heal thhis
tory,i
mmu nizati
ondet ail
s gr
owt hfort hec hi
ld.I ti
sapr ocessofgu i
ding
etc.Wewei ghandmoni torac hil
d’s chil
drent odevel opheal thys elf-es teem,
progres sandgi veadvic
ewher eappr opri
ate. r espectf ort hems el
vesandot her sand
Anyot hervac ci
neswi l
lbes u
ppliedbyt he skil
lstomanageanar rayofpot ential
patient. stressors
 Functions  F unc tions
Theywer er esponsibl
efort he  Chil
dG uidanc eC l
inics t
af fpr ovides
i
mmu nisation,thenu t
rit
ionoft hechil
dren compr ehens ive,i ntens ivement alhealth
throughmoni tor
ingoft hewei ghtc ur
ve, serv i
c es for ch ildrena n dt heirfami l
ies
.
advisingt hemot hersont hemeanst o Thisi nc l
udes :As sessment–t hrought hi
s
achieveanadequ atebirt
hi nter val,andt he proc es s,aps yc hologistwi llwor kwi t
hy our
treatmentofc ommonc ondi t
ions chi
ldt oeval u at et heirbehavi or,
pers onal ityand
c
apabi l
it i
es .
 Object i
ves  Obj ec t i
ves
 Moni t
orgr owt handdevel opmentoft he  P r
ovi di nghel pf orc hil
dr enwi th
chil
du ntil5y earsofage. behavi ou r
alpr obl em likepi c
a,bed
 I
dent ifyf actorsthatmayhi ndert he  we tting,
growt handdevel opmentoft hec hil
d. s
leepwal king,s peec hdef ec t
set c.
 P r
ovi di ngc ar e&gu idanc eforc hil
dren
withment alr et ardat i
on.
 P r
ovi di ngc ar e
forchildr enwi t
hl ear ningdi ffic
u l
ti
es .

 P
rovi
dingc
ouns
ell
i
ng&gu
idanc
e&
infor mat i
ont opar ent sregar dingc are
&u pbr i
ngingof
chi
ldren.
 Ac tivitiesandS t
rategi es  Ac ti
vi t
ies
 Re gu l
arhei ghtandwei ghtdet erminati
on/  Managi ngbehavi our alproblems .
moni t ori
ngu nti
l5y ear sol d.0-1year  Managi nglear ningdi ff
icul
ties.
old=mont hly1y earol dandabove  Managi ngemot i
onalpr oblems
=qu art er
ly  Managi ngadj ust mentpr oblems .
 Re cor dingofi mmu niz ation,vi t
ami ns  Managi ngdevel opment alpr obl
ems .
supplement ation,de wor mi ngandf eedi
ng.  Managi ngint ell
ec t
ualdef ici
t.
 P rovis i
onofI ECmat er i
als( ex.Posters
,  Managi ngs ociol egalissues
char t
s ,andt oy s)thatpr omot eand  Ac ti
vi t
iesandS trategies
enhanc ec hil
d’spr opergr owt hand  Re gularheightandwei ghtdet ermi nati
on/
development . moni tori
ngu nti
l5y earsol d.0-1y ear
 P rovis i
onofas afeandl earning old=mont hly1y earol dandabove
–orientedenvi ronmentf ort hec hi
ld. =qu ar ter
ly
 Moni tor i
ngandEval u at i
on.  Re cordingofi mmu ni z
at i
on,vi t
ami ns
suppl ement ation,dewor mingand
feeding.
 P rovi si
onofI ECmat eri
als( ex.P oster
s,
char ts,andt oy s)t hatpr omot eand
enhanc ec hil
d’spr opergr owt hand
devel opment .
 P rovi si
onofas af eandl earning
–orient edenvi ronmentf ort hec hi
ld.
  Moni
tor
ingand
Eval
uat
ion.

C
HARAC
TERI
STI
CS P
HENYL
KET
ONURI
A GAL
ACT
OSEMI
A

DEF
INI
TION I
tisagenet i
cdisorderthatis Galactosemiai
sadisorder
char
acter
isedbyani nabil
it
yofthe thatoc c
urswhenthebodyis
bodytoutil
iz
et heessenti
al unabletobreakdown at y
pe
aminoaci
d,phenylal
anine ofs u
garc al
l
edgalac
tosethat
i
sf oundi nmil
k&milk
products

S
IGNSAND  Amustyodou
rin  c
onvu
lsi
on
SYMP
TOMS br
eat
h,ski
noruri
ne
 i
rri
tabi
l
ity
 Neu
rol
ogi
calpr
obl
ems
 poorf
eedi
ng
 S
kinr
ashes
 poorwei
ghtgai
n
 Hy
per
act
ivi
ty

RI
SKF
ACT
ORS  Havingbothpar
entswit
ha  poorgr
owt
h
defect
ivegenet
hatcau
se
PKU  L
ear
ningdi
sabi
l
iti
es

 Bei
ngofcer
tai
net
hni
c  ovar
ianf
ail
ure
des
cent

DI
AGNOS
IS  s
creeni
ngf
orP
KUi
nvol
ves
:  pr
enat
alt
est
ing
 - Deter
minationof a.
amni
ocent
esi
s
phenyl
alani
nelevel
c
hor
ioni
cvi
l
luss
ampl
i
ngorc
vs
- TheGut
hri
ctestasa
 Newbor
nsc
reeni
ng
bact
eri
ali
nhi
bit
ionas
say

- Mol
ecu
lart
est
ing

C
OMP
LIC
ATI
ONS  I
rrever
sibl
ebr
aindamage  L
iverdamageorl
i
ver
f
ailu
re
 Neu
rol
ogi
calpr
obl
ems
 s
eriou
sbacter
ial
 Behavi
oural,
emot
ional& i
nfect
ions
soci
alpr
oblems
 s
hoc
k

 Del
ayeddevel
opment

C
HIL
DREN ADUL
T

ANATOMIC&  Newbornhavelar
gerand  Adul
tsheadisnot
PHYS
IOLOGI
CAL heavi
erhe
adc omparedt
o heavi
erthanbody
CHANGES hi
sbody
 S
kini
snotmu c
hthi
nner
 T
hinners
kint
hanadu
lt t
hanchi
l
dren

I
NTEGUMENT
ARY  Apocr
ines
weatgl and-
smal
l  Apoc r
ineglandare
S
YSTEM andnon-f
uncti
onalfrom properlydevel
ope
di n
bi
rthtopres
choolyears Axil
la,Areola&Genital
area

RESPI
RAT
ORY  Res
pir
ator
yRat
e:  Res
pir
ator
yRat
e:
SYS
TEM
3
0-6
0br
eat
hs/mi
n 1
6-2
0br
eat
hs/mi
n

 Hear
trat
e:  Hear
tRat
e:

1
00-
160beat
s/mi
n 6
0-1
00beat
s/mi
n

HEMATOL
OGI
CAL  Newbor
nRBCar
eMi
croc
yti
c  Adu
ltRBCar
eMac
roc
yti
c
SYS
TEM
 Li
fespanofRBCar
e60-
90  L
ifes
panofRBCar
e
days
1
00-
120day
s
 Bl
oodvol
ume-
 Bl
oodVol
ume-
8
5ml
/kgofBodyWei
ght
6
0-7
0ml
/kgofBW

URI
NARYS
YST
EM  I
nfant
'ski
dneyar
e  Ki
dney
'sar
emat
ure
 i
mmat ur
ewi t
hredu
ced enoughforpr
oper
abil
i
t yt
of i
l
terand func
tioni
ng
concent
rateuri
ne

GIS
YST
EM  Cardiacsphi
ncterof  Cardi
acsphi
nct
erof
stomac hisrel
axedin stomachisfai
rLiT
itan
i
nf antsresu
lti
ngin adult
s
frequentregurgi
tat
ionand
vomi ti
ngdur i
nginf
ancy

NEUROLOGI
CAL  Wei
ghtofbr
aini
nchi
l
dis  Wei
ghtofbr
aini
nadu
lt
SYS
TEM 3
00-
500gm i
s13
00-1
400gm