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Paediatrics (Respiratory (URTI (Otitis media, Epiglottitis, Sinusitis,…
Paediatrics
Respiratory
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LRTI
Bronchiolitis
RSV pathogen in 75-80% of cases
other causes - mycoplasma, adenoviruses
90% aged 1-9 months, peak incidence 3-6m
higher incidence in winter. maternal IgG protects newborns
RSV detected by PCR of nasopharyngeal secretions
coryzal symptoms precede dry cough, increasing SOB, wheeze +/- fine inspiratory crackles, increased resp effort (sub/intercostal recession, hyperinflation of chest)
feeding difficulties lead to admission
Management = mostly supportive
humidified oxygen, NG feeding may be necessary, suction if excessive secretions
palivizumab (monoclonal antibody against RSV) can be given monthly by IM injection to high risk preterm infants to reduce severity
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Neonatal Jaundice
in first 24 hours = pathological
- rhesus haemolytic disease
- ABO haemolytic disease
- hereditary spherocytosis
- glucose-6-phosphodehydrogenase
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HUS
triad of
- acute renal failure
- microangiopathic haemolytic anaemia
- thrombocytopenia
common causes - post-dysentry E coli 0157:H7, tumours, pregnancy, ciclosporin, the pill, SLE, HIV
treatment is supportive eg fluids, blood transfusion, dialysis if required
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