Wondershare EdrawMind
MindMap Gallery Pediatrics
- 32
- 1
- 1
Pediatrics
It mainly includes immune diseases, neonatal and neonatal diseases, cardiovascular system diseases, respiratory system, blood system diseases, urinary system diseases, etc.
Edited at 2024-01-12 09:21:06
- Avatar Character Relationship Chart
Avatar 3 centers on the Sully family, showcasing the internal rift caused by the sacrifice of their eldest son, and their alliance with other tribes on Pandora against the external conflict of the Ashbringers, who adhere to the philosophy of fire and are allied with humans. It explores the grand themes of family, faith, and survival.
- Zootopia 2 Easter Egg
This article discusses the Easter eggs and homages in Zootopia 2 that you may have discovered. The main content includes: character and archetype Easter eggs, cinematic universe crossover Easter eggs, animal ecology and behavior references, symbol and metaphor Easter eggs, social satire and brand allusions, and emotional storylines and sequel foreshadowing.
- Zootopia 2 Character Relationship Chart
[Zootopia Character Relationship Chart] The idealistic rabbit police officer Judy and the cynical fox conman Nick form a charmingly contrasting duo, rising from street hustlers to become Zootopia police officers!
Pediatrics
- Avatar Character Relationship Chart
Avatar 3 centers on the Sully family, showcasing the internal rift caused by the sacrifice of their eldest son, and their alliance with other tribes on Pandora against the external conflict of the Ashbringers, who adhere to the philosophy of fire and are allied with humans. It explores the grand themes of family, faith, and survival.
- Zootopia 2 Easter Egg
This article discusses the Easter eggs and homages in Zootopia 2 that you may have discovered. The main content includes: character and archetype Easter eggs, cinematic universe crossover Easter eggs, animal ecology and behavior references, symbol and metaphor Easter eggs, social satire and brand allusions, and emotional storylines and sequel foreshadowing.
- Zootopia 2 Character Relationship Chart
[Zootopia Character Relationship Chart] The idealistic rabbit police officer Judy and the cynical fox conman Nick form a charmingly contrasting duo, rising from street hustlers to become Zootopia police officers!
- Recommended to you
- Outline
Pediatrics
The most important thing is clinical manifestations
urinary tract disease
acute glomerulonephritis
Differential diagnosis
Treatment is non-specific
rest
Strictly stay in bed until gross hematuria disappears, edema subsides, and blood pressure becomes basically normal.
go to school
ESR is normal
resume physical work
Addis count is normal
diet
low salt diet
Restrict sodium until edema subsides and blood pressure becomes normal
Azotemia, protein restriction
Anti-infective
penicillin
Purpose: Completely eliminate remaining bacteria in the body
Symptomatic
diuretic
Hydrochlorothiazide
Furosemide
hypotensive
nifedipine
Severe circulatory congestion treatment
Correct blood volume and inject furosemide
Pulmonary edema, sodium nitroprusside
Hypertensive encephalopathy treatment
step down
Sodium nitroprusside is preferred
Antispasmodic
Nephrotic syndrome NS
feature
Increased filtration membrane permeability ➡️Proteinuria ➡️Hypoalbuminemia ➡️Pitting edema, hypovolemic shock, hypercholesterolemia (apolipoprotein loss), susceptibility to infection (immunoglobulin loss), thrombosis (concentration)
Classification
According to clinical manifestations
simple nephropathy
nephritic nephropathy
Glucocorticoid response
hormone sensitive nephropathy
hormone-resistant nephropathy
hormone-dependent nephropathy
Renal disease recurrence and frequency
clinical manifestations
typical
massive proteinuria
Hypoalbuminemia
Hyperlipidemia
Marked edema (pitting edema)
complication
Infection (most common)
Common in respiratory tract
Electrolyte imbalance (low sodium, low potassium, low calcium)
hypovolemic shock
Thrombosis (most common in renal veins)
acute renal failure
renal tubular dysfunction
examine
Urinalysis
Serum protein, cholesterol and renal function measurements
Serum complement assay
Minimal change type or simple multiple normal
Decreased nephritis
Serological testing for systemic diseases
Testing for hypercoagulability and thrombosis
Transrenal puncture histopathological examination
diagnosis
Simple nephropathy (mainly minimal change disease)
massive proteinuria
hypoalbuminemia
Hyperlipidemia
Edema
Nephritic kidney disease (non-minimal change type)
"Three highs and one low" (simple NS)
persistent hematuria
Three urine sediment RBC>=10/HP within two weeks
Azotemia-renal insufficiency
hypertension
Persistent hypocomplement C3emia
treat
generally
Proteinuria-lowering treatment
hormone
in principle
Take enough amount at first, reduce it every other day, and maintain it for a long time
Oral prednisone (preferred)
side effect
Metabolic disorders
hypertension
Peptic ulcers and mental euphoria
prone to infection or induced tuberculosis activity
Acute adrenocortical insufficiency, withdrawal syndrome
immunosuppressant
Preventing the chronic development of renal pathology and treating chronic complications
Anticoagulant and fibrinolytic drug therapy
immunomodulator
ACEI
urinary tract infection
Cause
allGirls➕Boys under 1 year old
Escherichia coli
Boys over 1 year old
Proteus
examine
Urine bacterial culture
>10^5 diagnosed
10^4～10^5 is suspicious
<10^4 contamination
treat
symptomatic urinary tract infection
lower urinary tract
amoxicillin/clavulanate potassium
Upper urinary tract or urinary tract malformation
Broad-spectrum or two antibacterial drugs (such as ceftriaxone or cefotaxime intravenously)
asymptomatic bacteriuria
Generally no treatment required
Combined with obstruction, reflux or other malformations
Antibacterial treatment first, then low-dose prevention
acute renal failure
treat
Remove the cause and treat the primary disease
diet and nutrition
Control water and sodium intake
Correct acidification
correct electrolytes
dialysis
cardiovascular system diseases
congenital heart disease
left to right shunt
Cause
Intrauterine viral infection (most important)
Common feature
Decreased blood volume in systemic circulation
aortic node narrowing
Retarded growth and development
Easily tired and difficult to feed
Increased pulmonary circulation blood volume
Lung field congestion and increased lung markings
prone to pneumonia
Pulmonary artery shadow protrusion, hilar dance
Hoarseness, elevated second heart sound
Classification
Housing shortage
Left atrium➡️Right atrium➡️Right ventricle➡️Pulmonary circulation➡️Left atrium
Classification
Primary hole pattern
Pore secundum pattern (most common)
clinical manifestations
physical signs
Second heart sound fixed split
Systolic murmur in the second intercostal space at the left sternal border
Principle: Pulmonary valve relative stenosis
Auxiliary inspection
Imaging features
The right atrium and right ventricle are enlarged, and the pulmonary artery segment is prominent
"hilar dance"
electrocardiogram
Right axis deviation, incomplete right bundle branch block
Room shortage (most common)
Left ventricle ➡️Right ventricle ➡️Pulmonary circulation ➡️Left atrium ➡️Left ventricle
The left atrium, left ventricle, and right ventricle are large
Small right heart
Classification
Small ventricular septal defect (Roger's disease)
Auxiliary inspection
X-ray
Enlargement of left and right ventricles
Mainly left ventricular enlargement
complication
bronchitis
congestive heart failure
Pulmonary Edema
infective endocarditis
Patent ductus arteriosus
Descending aorta➡️ductus arteriosus➡️pulmonary artery➡️pulmonary circulation➡️left atrium➡️left ventricle➡️aorta
clinical manifestations
peripheral vascular sign
Shuichongmai
Nail bed capillary pulsation
gunshot sound
Auxiliary inspection
Aortic node normal or prominent
treat
intervention
Take indomethacin within 1 week
complication
Pneumonia (common)
right to left shunt
Tetralogy of Fallot
Tetralogy
Right ventricular outflow tract obstruction
ventricular septal defect
aortic straddling
right ventricular hypertrophy
clinical manifestations
blue and purple
Squatting
Clubbing of fingers
paroxysmal hypoxic attack
Cause: Pulmonary artery infundibulum muscle spasm
complication
infective endocarditis
cerebral thrombosis
brain abscess
Hemoptysis
respiratory system
Anatomy, physiology, immune characteristics, examination methods
Anatomy
Upper respiratory tract (above cricoid cartilage)
tonsil
palatine tonsils
Pharyngeal tonsils (adenoids)
The main causes of sleep-apnea syndrome in children
Lower respiratory tract (below the cricoid cartilage)
Physiological characteristics
respiratory function
vital capacity
50～70ml/kg
Small respiratory reserve
acute upper respiratory tract infection
Cause
clinical manifestations
special
herpangina
coxsackievirus group A
Pharyngeal conjunctival fever
Adenovirus
treat
General treatment (most important)
Cause treatment
Symptomatic treatment
bronchiolitis
Under 2 years old, up to 6 months
Rarely high fever
Bronchial Asthma
diagnosis
Diagnostic criteria
symptom
Treatment is effective
exclude others
Clinically atypical
Reversible airflow limitation
Provocation test positive
mutation rate
Diagnostic criteria for cough variant asthma
treat
Drug Classification
Anti-inflammatory
Glucocorticoids ICS
leukotriene receptor blockers
Montelukast, Zafirlukast
Expansion
beta receptor agonists
Short-acting: albuterol, terbutaline
Long-acting: salmeterol
Anticholinergics (M-resistance)
Short-acting: ipratropium bromide
Long-acting: Cytropium bromide
Theophylline
medical treatement
acute attack period
first line
(Preferred) Short-acting beta2 receptor agonists
Glucocorticoids intravenously or orally
second line
chronic duration
first line
(Preferred) Inhaled corticosteroids
Long-acting beta2 receptor agonist
Pneumonia classification
Anatomy
Lobar pneumonia
Bronchopneumonia
interstitial pneumonia
Course of disease
Acute (<1 month)
Persistence (January to March)
Chronic (>3 months)
illness
Lightweight
severe
Are clinical manifestations typical or not?
Location occur
CAP
HAP
Bronchopneumonia
Cause
Most common: Bacterial and viral infections
pathology
Hypoxia➕Carbon dioxide retention➕Toxins
clinical manifestations
Severe pneumonia
Cardiovascular System
Heart rate and breathing suddenly increase
nervous system
toxic encephalopathy
digestive system
toxic intestinal paralysis
severe abdominal bloating
Bowel sounds disappear
gastrointestinal bleeding
Syndrome of inappropriate antidiuretic secretion (cerebral hyponatremia)
DIC
complication
Empyema
Pyopneumothorax
bullae
lung abscess
diagnosis
Clinical manifestations➕X-ray➕Etiology
treat
generally
Antibacterial
Streptococcus pneumoniae
penicillin
Staphylococcus aureus
Sensitivity: oxacillin, cloxacillin
Haemophilus influenzae
Amoxicillin/clavulanic acid, ampicillin/sulbactam
Escherichia coli, Klebsiella pneumoniae (G-)
Cephalosporins
Mycoplasma, Chlamydia
Macrolides (azithromycin, erythromycin, roxithromycin)
Symptomatic
Glucocorticoids (must be combined with antibiotics)
subtopic
complication
Characteristics of several common pneumonias
Virus
respiratory syncytial virus
Under 1 year old
Suffocation (symptoms similar to those of asthma)
X-ray: Emphysema
Adenovirus pneumonia
6 months to 2 years old
Urgent, hot, severe
X-ray changes appear early, take early pictures (easy to consolidate)
bacteria
Staphylococcus aureus
Newborns, infants and young children
Acute, hot (relaxing fever), fast, severe; rash
X-ray, rapid changes
G-bacteria pneumonia
subacute
Large-leaf nature
other
Mycoplasma
Many years old
Irritating dry cough
X-ray: cloudy shadow
Chlamydia
Chlamydia trachomatis pneumonia
baby
conjunctivitis
chlamydial pneumonia
5 years and above
Digestive system diseases
congenital disease
congenital hypertrophic pyloric stenosis
clinical manifestations
symptom
Vomiting (no bile)
jaundice
physical signs
Mass in right upper abdomen
examine
Ultrasound (preferred)
X-ray barium meal
bird's beak sign
treat
Surgery (pyloromyotomy)
Hirschsprung disease
clinical manifestations
symptom
Delayed bowel movement, persistent constipation, bloating
Vomiting, malnutrition, stunted growth
Vomiting with bile and occasional feces
physical signs
Digital rectal examination
The ampulla is empty, and foul-smelling gas and stool are discharged after pulling out the finger.
examine
X-ray
First choice: barium enema
treat
Resection of aganglionic intestinal segments and dilation
Diarrheal disease
Cause
infectious agents
Viruses, bacteria, fungi, etc.
non-infectious factors
clinical manifestations
Acute (<2 weeks)
common expression
gastrointestinal symptoms
Dehydration and electrolyte imbalance
dehydration
According to the degree of dehydration
Mild dehydration
Slightly less energetic, slightly dry skin, slightly sunken anterior fontanel, warm limbs
Dehydration 30～50ml/kg
moderate dehydration
Listlessness, markedly dry skin, markedly sunken anterior fontanelle, and cold limbs
Dehydration 50～100ml/kg
severe dehydration
Apathy/lethargy, extremely dry skin, deeply sunken anterior fontanelle, cold limbs
Dehydration 100～120ml/kg
According to dehydration properties
Isotonicity
Most common
Hypotonic
prone to shock
Hypertonic
easily irritable
metabolic acidosis
Features
Breathe deeply, lips turn red
Hypokalemia (<3.5mmol/L)
Clinical features
Decreased neuromuscular excitability (wilting)
Often appears after rehydration
The reason does not appear before rehydration
Dehydration causes blood to become concentrated
Acidosis, potassium ions leave cells
Oliguria, little excretion
Reasons for low potassium in fluid rehydration
fluid replacement, blood dilution
Acidosis is corrected and potassium is returned to cells
Increased urine output and potassium excretion
Input large amounts of glucose (synthetic glucose consumption)
The diarrhea continues and the diarrhea continues
Hypocalcemia and hypomagnesemia
clinical manifestations
smoke!
It often occurs after rehydration (if calcium supplement is not effective, consider low magnesium)
Symptoms of systemic infectious poisoning
Characteristics of common types of enteritis
rotavirus
Watery or egg-like stool, with few white blood cells in the stool
spring and winter
Toxigenic bacteria
(same as above)
Much summer
Invasive bacteria
category
Invasive Escherichia coli
Campylobacter jejuni
Yersinia
Typhimurium
Mucus, pus and bloody stools, tenesmus (distinguishable from dysentery)
Stool red blood cells, white blood cells
Antibiotic related
Staphylococcus aureus
Yellow/dark green stool
Fungal
Candida albicans
Bean dregs
pseudomembranous enterocolitis
Durability (2 weeks to 2 months)
Chronic (>2 months)
diagnosis
acute? Chronic? Persistence?
Lightweight? Heavy duty?
Viral? Bacterial?
Differential diagnosis
Mainly "diarrhoea"
Physiological diarrhea
Within 6 months
May be related to lactose intolerance
Lactase deficiency diarrhea
allergic diarrhea
Mainly "death" (bloody pus and stool)
bacillary dysentery
necrotizing enteritis
treat
diet therapy
No food, no water
medical treatement
Intestinal mucosal protective agent (montmorillonite powder)
Zinc supplementation (promotes intestinal mucosal repair)
Avoid using antidiarrheal drugs for infectious diarrhea! !
Rehydration
oral rehydration solution
ORS
Mild: 50～80ml/kg
Moderate: 80～100ml/kg
intravenous fluids
Fluid replacement volume
Mild: 90～120ml/kg
Moderate: 120～150ml/kg
Severity: 150～180ml/kg
Rehydration properties
Isotonic
1/2 piece (2:3:1)
Hypotonic
2/3 sheets (4:3:2)
Hypertonic
1/3 sheet (1:2 liquid-alkali-free)
Expansion/Shock
Isotonic (2:1 isotonic sodium-containing solution, sugar-free)
Rehydration speed and stages
Expansion
Anti-shock (only for severe dehydration)
Speed: 20～40ml/kg·h
Time: 0.5～1h
isotonic
Rapid rehydration phase
Cumulative loss (total requirement 1/2 - expansion)
Speed: 8～10ml/kg·h
Time: 8～12h
nature
Isotonic 1/2 sheet
Hypotonic 2/3 pictures
Hypertonic 1/3
Maintain rehydration phase
Continued loss➕Physiological requirements (1/2 of the remaining total)
Speed: 5ml/kg·h
Time: 12～16h
1/3～1/5 sheets
correct electrolytes
Potassium supplement
Mild, oral
Moderate and severe, intravenous drip
Infectious diseases
measles
Pathogen
measles virus
Clinical manifestations (3 days in the first phase)
"The rash is hot and intense"
incubation period
fever
Upper respiratory tract catarrhal symptoms
conjunctivitis
measles mucosal spots
prodromal stage
Measles mucosal spots (koplik spots)
Fever (highest)
Rash period
regression period
tan pigmentation
bran-like desquamation
complication
Pneumonia (most common)
myocarditis
nervous system
measles encephalitis
subacute sclerosing panencephalitis
Tuberculosis worsens
Malnutrition and vitamin A deficiency
examine
Blood routine
Multinucleated giant cell examination
serology test
Viral antigen test
Virus isolation
Differential diagnosis
rubella
No pigmentation or scaling
Urgent rash in young children
High fever for 3 to 5 days, then the fever subsides and the rash appears
scarlet fever
Rash recedes with peeling
enterovirus infection
Purpuric or vesicular rash
drug rash
treat
General treatment
Symptomatic treatment
Vitamin A supplement
Treatment of complications
polio
clinical manifestations
prodromal stage
Pre-paralysis
paralysis period
recovery period
sequelae period
laboratory tests
cerebrospinal fluid
Increased lymphocytes in the pre-paralytic and paralytic stages
chicken pox
clinical manifestations
Incubation period 2 weeks
treat
No hormones
infectious mononucleosis
Epidemiology
Route of infection: mouth-to-mouth transmission
Mainly against children and teenagers
pathology
benign proliferation of lymphocytes
Hand, foot and mouth disease
Pathogen
Enterovirus 71
Epidemiology
Human - the only host
way for spreading
Fecal-oral route of transmission
It takes 3 to 5 weeks for the virus to be excreted in the feces
clinical manifestations
"Four no's"
No pain, no itching, no scabs, no scars
Sporadic rashes and herpes can be seen on hands, feet, mouth, and buttocks
Severe (cumulative neurological, respiratory, circulatory)
examine
Blood routine
Blood chemistry
blood gas analysis
cerebrospinal fluid
etiology
Serology
X-ray
NMR
treat
ordinary
Symptomatic
severe
Nervous system involvement
Control intracranial hypertension
Use glucocorticoids
Injection of immune globulin
Symptomatic
Respiratory and circulatory failure treatment
oxygen
monitor
Treat respiratory dysfunction
Protect important organs
recovery period
Promote recovery of various organs
functional rehabilitation treatment
Integrated Traditional Chinese and Western Medicine Treatment
tuberculosis
Summary
Epidemiology
Source of infection
patients with open pulmonary tuberculosis
way for spreading
airborne
Small amount of gastrointestinal spread
Susceptible groups
Pathogenesis
Mycobacterium tuberculosis
cellular immunity
Type IV allergy
Primary tumor in lung
get better
completely absorbed
Calcification
Induration
progress
Caseous pneumonia
pleurisy
miliary tuberculosis
Hematogenous dissemination
tuberculous meningitis
diagnosis
Medical history
tuberculin test
clinical significance
The only way to detect asymptomatic infection
result
Positive
Vaccination with BCG vaccine
Older children, generally positive, past infection
Unvaccinated infants and young children with active tuberculosis
Infants and young children who have not been vaccinated, changed from negative to positive, and are newly infected
Strongly positive, active tuberculosis
Negative
Not infected
window period
false negative
critical tuberculosis
After acute infectious diseases (measles, chickenpox, etc.)
severe malnutrition
Immunosuppression or immunodeficiency
technical error
treat
prophylactic antituberculosis treatment
Single drug, 6 months; double drug, 3 months
primary pulmonary tuberculosis
pathology
primary syndrome
primary lung lesions
regional pulmonary lymphadenopathy
linked lymphangitis
clinical manifestations
Hyperallergic children
Herpetic conjunctivitis of the eye
Erythema nodosum of the skin
polytransient arthritis
enlarged lymph nodes compressing
Compression of the trachea: whooping cough-like spasms
Compression of bronchial tubes: stridor
Compression of the recurrent laryngeal nerve: hoarseness
diagnosis
Medical history➕Clinical manifestations➕Laboratory tests➕Tuberculin test➕Pulmonary imaging
treat
no obvious symptoms
Double medicine: September to December
Mobility
strengthen ➕consolidate
tuberculous meningitis
pathology
"Tuberculous Panencephalitis"
Meningeal lesions
cerebrovascular disease
cranial neuropathy
parenchymal brain lesions
Hydrocephalus and ependymitis
myelopathy
clinical manifestations
Early days
personality change
Elderly child, headache
medium term
Late stage
Coma, impaired consciousness
Frequent convulsions
diagnosis
Medical history➕clinical manifestations➕PPD test➕X-ray➕cerebrospinal fluid
cerebrospinal fluid
ground glass
Increased protein (the highest increase in cerebrospinal fluid protein in tuberculous meningitis)
The number of cells increases, 50 to 500, mainly lymphocytes (if it is metabolized, the number is more than 1000, mainly neutrophils)
tuberculin test
Children have a higher false negative rate (up to 50%)
identify
purulent meningitis
Bacterial culture, pyogenic bacteria
viral meningitis
cryptococcal meningitis
Ink dyeing➕
brain tumor
treat
antituberculosis treatment
Treatment➕Consolidation
Consolidate until half a year after the cerebrospinal fluid turns negative
Reduce intracranial pressure (major cause of death)
Glucocorticoids (symptomatic)
8 to 12 weeks (February)