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 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 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 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 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
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 HirotoShishido
