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Paeds (Growth/Endo (Puberty (Breast, testicular enlargement. 11.5, 13.5,…

- - - - Late weaning, periods of illness, feeding prob, "too healthy"
    - - Coeliac, :hearts:, lung, kidney insuff
- - - - Unexplained in <2y, any in <6m, multiple injuries different ages, immersion scald, genital bleed
      - Refer to senior, then to social services
  - - - Anaphylactic rxn to antigen/component, (eggs/latex)
      - Live vaccine
        
        :red_cross: in preg, immunosupp (transplant, cancer, chemo, HIV)
- - - - Hip/knee pain + limp, :arrow_down:abd, IR
        Patchy, flattened epiphysis
        Rest
    - - Knee/hip pain + limp in teen, ER leg.
        Asso w/ hypothy, CRF, prev radio/GH
        Pin in situ
    - - :red_flag:<4y, >4w, night pain, limit movement/fn disability, neuro sign,
  - - - Tibial tub tender + swelling
        Activity restrict
    - - Worse w/ squat, stairs, long flex
        Activity mod, avoid, quads strength ex
    - - Bilat, Quickly resolve, return to sleep, N fn next day, N exam
  - - - :warning:Pseudoparalysis neonate = sepsis until otherwise
      - Vs. transient synovitis/reactive arthritis
        
        T>38.5, unable to WB, ESR>40, WBC>12
    - - Classic: Unwell, fever, erythema, pain. MC subacute (recent VZV, point tenderness, night pain, lump)
    - - Rheumatic fever
        
        JONES CAFE PAL
        
        Major: joint, :hearts:myocarditis, nodules, erythema marginatum, Sydenham's chorea
        
        Minor: CRP, athralgia, fever, ESR, PR :arrow_up:, Antecedent RF, Leukocytosis
        
        DX: Recent strep (throat culture/rapid strep antigen test/ASO titre) + 2M/1M+2m
      - Reiter's syn
        
        Can't see, pee, climb a tree! :palm_tree: :monkey:
        HLA B27
      - Transient synovitis of hip #
        
        Post-infection, Flexed, ER hip + limp.
        USS (effusion), ESR/WCC N
  - - - Persistent swelling, inflamm features ( :sunrise:stiff,warmth)
        Chr ant uveitis :arrow_right:blindness, ref opthal regular screen
    - - Small VV. Purpura (X-blanching) over butt/extensor, joint, abdo pain, GN
    - - Medium VV. Fever, conjunctivitis, cervical LN, injected pharynx/ :strawberry:tongue, polymorphous rash, palmar erythema/desquamation.
        Coronary aneurysms - ECHO
      - Tx: IV IG + aspirin
- - - - :flags: Ref SALT, hearing test
      - familial, hearing impaired, autistic, deprived