management of hypospadiasDefer circumcision
★Urologic evaluation for surgical repair
+ ★Karyotype, pelvic ultrasound (★if severe hypospadias (eg, scrotal/perineal urethral meatus) with bilateral, nonpalpable gonads may be indicative of a disorder of sex development (DSD)) reproductivepediatricsUWorld step2CK Sep 20, 2020, 6:25 AM HirotoShishido
management of nocturnal enuresisEnuresis alarms are the most effective long-term intervention but can take 3-4 months to be effective.
Pharmacotherapy with ★desmopressin is also considered first-line therapy for those who desire immediate improvement. pediatricsrenalUWorld step2CK Sep 20, 2020, 5:26 AM HirotoShishido
pharmacokinetic difference between neonatal patients and adults↑Proportion of body water
Blood-brain barrier immaturity
→☆↑Distribution of water-soluble drugs(eg aminoglycosides, vancomycin) may necessitate higher mg/kg dose, ↑CNS toxicity
congenital torticollistypically develops by 2 to 4 weeks of age
It is most commonly caused by birth trauma (eg, breech delivery) or ☆malposition of the head in utero (eg, due to fetal macrosomia or oligohydramnios),both of which can result in sternocleidomastoid muscle(SCM) injury and fibrosis. OBGYpediatricsUWorld Jun 16, 2020, 9:53 AM HirotoShishido
neonatal intraventricular hemorrhage
sourse of bleeding, predisposing factor☆germinal matrix (sources of neurons and glial cells during brain development)
IVH almost always manifest within the first 5 postnatal age in patients born before 32 weeks gestation and/or with birth weight<1500 g neurologypediatricsUWorld May 20, 2020, 3:42 AM HirotoShishido
cretinism
symptoms, management6P
Pot-bellied, Pale, Puffy-faced child, with Protruding umbilicus
→(★)umbilical hernia, ☆Protuberant tongue, and Poor brain development
+hypotonia, (★)sluggish movement, lethargy, ☆enlarged fontanelle, constipation→ bloating
Pierre Robin sequencemicrognathia, glossoptosis, cleft palate, airway obstruction(☆improve with prone position)
☆A sequence occurs when a single developmental defect causes a cascade of additional malformations. embryologypediatricsUWorld May 13, 2020, 10:15 PM HirotoShishido
shaken baby syndrome
manifestationsacute on chronic subdural hemorrhages
rentinal hemorrhages
posterior rib fractures neurologypediatricsUWorld Apr 21, 2020, 10:11 AM HirotoShishido
Rett syndromede novo mutations in the X linked MECP-2 gene
normal development until age 6-18 months,follwed by a loss of motor and language skills and development of ☆stereotypic hand movements(hand stereotypies)
Gait abnormalities((★)lurching gait)
Head growth deceleration → ★microcephaly
Seizures
Breathing abnormalities
Sleep disturbance
Autistic features geneticspediatricsUWorld step2CK Apr 16, 2020, 1:50 AM HirotoShishido
6 month developmental milestonesrolls and sits
passes toys hand to hand
stranger anxiety
babble reproductivepediatrics Jan 2, 2020, 7:36 PM HirotoShishido
