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PEDIATRICS

Common causes in Child

 Haematemesis = Acute duodenal ulcer

 Bleeding per rectum = Fissure in ano/Pollyp
 Haemoptysis = Pneumonia
 Constant crying = Hunger
 Commonest emergency in new bone = Resuscitation
 Commonest cause of Fever in child = Upper respiratory Infection
 Commonest Paediatric Complaint = Upper Respiratory Intection
 Commonest malignancy in Children = Leukemia
 Commonest complication of Ramstaedt's operation = Hypothermia

A- Prenatal Period –
Ovum = 0 to 14 days
Embryo = 14 days to 9 weeks
Foetus = 9 weeks till birth

B- Perinatal Period

(From 28 weeks of gestation to 7 days after birth)

C- Post natal Period New born

New born = birth to four weeks
Infant = 7- 8 year of life
Pubescent = (12-14 years in girls)
(14-16 years in boys )

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Length of Child Weight

 At birth - 50 cm  At birth- 2.8 kg

 1 yrs - 75 cm  5 months - Double wt
 2 yrs - 85 cm  1 yrs - 3 times
 3 yrs -95 cm  2 yrs. - 4 times
 4 yrs. - 100 cm  3 yrs. - 5 times
 4 yrs - 6 times

Double

 Length – 4 yrs;
 Weight – 5 Months

 After birth there is weight loss of child in 1st week (10 % wt. Loss)
 Average birth weight of Indian new born = 2.8 kg.

At Birth

 Height = 50 Cms.
 Head circumference = 35 cm. ( 13.75 Incnes )
 Chest circumference = 32 cm.

 Equal Head and Chest Circumference upto = 1 to 2 years

 Length of umbilical cord = 50 cm..

 Pulse rate at birth = 140/min.
 Respiratory rate = 28/min.
 Blood Pressure = 60/40 mmHg
 Number of fontanellae at birth- 6
 Preterm baby = < 37 weeks gestational period)
 Low birth weight (LBW) baby < 2.5 Kg.
 Very low birth weights baby - < 1000 mg

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Moro Reflex = 3 months

Stapings Reflex = 6 weeks

Placing Reflex = 6 weeks

Palmar grasp = 6 months

Sucking and Rooting = 5-7 months

Plantar grasp = 10 months

Pinser Grasp = 9-11 months

Social smile = 2 months

Recognizing mother = 3 months

Holds object = 4 months

Sitting on slight support = 5 months

Sits alone momentally = 6 months

Sits alone steadily = 7-8 months

Speaks DADA, MAMA, NANA = 9 months

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Creeps = 10 months

Walk alone = 13-14 months

Feeds itself = 18 months.

Know age and Sex = 3 years

Bladder control - Diurnal = 12-16 months

Nocturnal = 2% to 3 Years.

 Vaginal bleeding appear in some child at 3 to 7 days of birth. (No need to management)
 Breast engorgment seen in child at 3/4" day of birth (No need to treat)
 Physiological jaundice in children appears after 48 hrs of birth and disappears by 7 days
while pathological Jaundice appear within 48 hrs of birth
 Umbilical hernia gets normal up to 3 to 4 years
 Bowed legs normal up to 2 years
 Marasmus is a carbohydrate deficiency while Kwashiorker is theProtein deficiency
disease
 Flag sign and moon face is found in Kwashiorker while monkey face is found in
marasmus
 Main pathological feature of tuberculosis - caseous necrosis
 Milliary tuberculosis occurs usually within 1 year of primary complex
 Posterior fontanellae close at the age of 4 months and Ant Fontanelle close at the 9-18
months.
 New born passes urine within 24 hrs. and passes stool (meconium) within 12 hrs of birth.
 Commonest malignancy in children = Leukemia
 Commonest heart disease in child = Rheumatic heart disease

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Head Circumferance

 At birth-Average - 13.75 Incnes

 At 6 month - 17 Inches
 At one year-18 Inches
 At two years - 19 Inches

 Cell mediated Immunity is responsible for Transplantation immunity, Monocytes are

the Blood macrophages and Histocytes are the tissue macrophages
 1st set immunity is cell mediated immunity and 2nd set immunity is Antibody
Immunity
 Cell mediated Immunity is responsible for Transplantation immunity Anaphylactic
reaction is mediated by IgE.
 Fetus is an Intrauterine allograft
 Tumour is an allograít
 Bone and arterial grafts are dead grafts
 Heart and Kidney are vital graft

Immunization - Immunization is the process of inducing immunity artificially by either

vaccination or administration of Antibody

Immunobiologics : This term is used for antigen substances such as vaccines, toxoids,
Immunoglobines and Antitoxins, these are used to produce active or passive immunization.

Vaccine - A suspension of infectious Agent given for the purpose of establishing resistance
to an infectious disease.

Toxoid - A modified bacterial toxin, that has been made non toxic, but retain the capacity to
stimulate the formation of Antitoxin.

Immunoglobulin - These are Antibody containing solution.

Antitoxin - These are Antibody derived from serum of Animal, after stimulation with
specific antigen used for passive immunization,

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Types of Antigen Examples

Live bacteria, Attenuated BCG

Killed bacteria Pertussis, Sol. Typhi
Live virus, Attenuated OPV, MMR
Killed virus IPV, Rabies, HAV
Toxoids DT, TT
Viral Sub unit HBs Ag
Capsular Polysaccharide Pneumo,meningo

Birth BCG, OPV-0

6 weeks/1.5 months DPT 1 , OPV-1
10 weeks /2.5 months DPT 2 , OPV-2
14 weeks /3.5 months DPT 3 , OPV-3
9 months Measles
15 months MMR
16 - 18 months DPT (booster), OPV-4
5 years DT
10 years TT
16 years
Pregnants Women TT(2 doses at 4 weeks interval)

 1st dose at = 6 months of Pregnancy

 2nd dose at = 8 months of Pregnancy
 Not other vaccine should be administered within 4 weeks interval after
administration of measles/MMR vaccine.
 Pertusis = not recommend after 5 yr, of Age
 DPT, TT and Typhoid vaccines should not be frozen

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Main Vaccines

Sample Vaccine = For Rabies

Salk Vaccine = Killed Polio vaccine (Parentral use)

Sabin vaccine = live oral polio vaccine (OPV)

Schwartz vaccine = for measles

Main immunoglobulins

 All'Antibodies are immunoglobulins but all immunoglobulins are not Antibodies

 Immunoglobulins are chemically glycoprotein
 Placenta is the source of human gamma globulins
 IgG is the smallest and warm Ig, and it can cross the placenta
 IgM is the largest, cold and Earliest Immunoglobulin to be synthesized
 Commonest Immunoglobin deficiency = IgA
 Ig present in milk = IgG and IgA

IMP POINTS
 VSD – Ventricular Septal Defect
 Cortraction of Arota
Trilogy -  Pulmonary Stenosis

FALLOT’ S Tetralogy -  Triology +

 RVH – Right Ventricular Hypertrophy

Pentalogy  Tetralogy +
 LVH – LEFT Ventricular Hypertrophy

 2014
 Includes 7 Vaccine
DPT, T.B, Polio,Hep B, Measles

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ORS FORMULATION - According WHO

Content gm/L (New) gm/L (Old)

Sodium chloride (NacL) 2.6 3.5

Glucose, anhydrous 13.5 20.0

Potassium chloride (KCI) 1.5 1.5

Trisodium Citrate Dihydate 2.9 2.9

 P'ABA (Para Amino Benzoic Acid) present in breast milk prevents the infection of -
Plasmodium Vivax (MH 2014)
 Craniosynostosis - Head circumference is >2 z-score above mean for the age, height
and gender (ATAPGET 2017)
 Recommended prophylactic dose of vit "A" in children of above 1 year age is - 2 lakh IU
(NIA+JAM 2011)
 What is the complication found in neonates; if chloramphenical is used by gravid
woman? - Bone marrow depression (NIA+JAM 2011)
 One year child have vomiting and diarrhoca but there is no oedema and weight ofchild is
62% of his normal weight. Then in which grade of P.E.M. he should be classified - PEM II
(NIA 2007)
 Jelly like bloody stool in baby is found in - Intestinal Intussusception (NIA 2012)
 Xerophthalmia in child occurs due to deficiency of - Retinol (JAM 2007)
 Jaundice occurs in a neonate within 24 hrs. of the birth, what may be expected cause
Rh Haemolytic disease
 TAB vaccine is used in - Typhoid (NIA 2005, BHU 2001)- monovalent vaccine
 A new born is born with multiple fracture, what could be the possible cause
Osteogenesis Imperfecta (BHU 2007)
 Prophylaxis dose of vitamin D in children is - 400 IU/Day (BHU 2007)
 Dose of Vit. A in children is - 500g (BHU 2008)
 Prophylaxis use of Vit. A should be started to every infant - 4 months of age (BHU
2007)

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 Brushfield spots - Rubella (BHU 2008)

 Moon face - Cushing's syndrome (BHU 2003)
 Tripod sign - Poliomyelitis (MH 2014)
 What may be fatal in a neonate an on the 2nd day of the birth - Jaundice
 कम शरीर भार वाले शशशु की पररचचाा में शकसका शवशेष ध्यान रखना चाशिये - Body
Temperature
 2 वषा की आयु के बालक का वजन उसके जन्म के बजन से प्रायः शकतना गु ना िोना चाशिये –
7 times
 Length of umbilical vein in a new born - 2-3cms. (DSRRAU 2013)
 ICMR के अनुसार 1-2 वषा के बच्ोों के शलये आवश्यक प्रोटीन की मात्रा िै -1.46gm/kg
(DSRRAL 2013)
 Which vitamin deficiency may cause convulsions in Neonates? - Pyridoxine (MH
2015)
 17 D vaccine For – Yellow fever

BHU- 1ST Rank

AIR – 49TH RANK
( PG Scholar )
INSITUTE OF MEDICAL SCIENCES – BHU VARANASI

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