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• Dr.Danil Hammoudi

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OSTEOARTHRITIS IS LEAST LIKELY TO BE ASSOCIATED
WITH

• ULCERATIVE COLITIS

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OSTEOARTHRITIS ASSOCIATED WITH

• GOUT
• HEMOPHILIA
• WILSONS DISEASE
• EHLERS DALOS SYNDROME

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AMBIGOUS GENITALIA

• ADRENAL HYPERPLASIA

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EYES MUSCLES ABDUCTING EYEBALL

• INTERNAL RECTUS

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EXTRINSIC EYE MUSCLES AND ROLE
MUSCLE INNERVATION MOVEMENT
LATERAL RECTUS ABDUCENS VI LATERAL
MEDIAL RECTUS OCULOMOTOR III MEDIAL
SUPERIOR RECTUS OCULOMOTOR SUPERIOR AND MEDIAL
INFERIOR RECTUS OCULOMOTOR INFERIOR AND MEDIAL
INFERIOR OBLIQUE OCULOMOTOR SUPERIOR AND LATERAL
SUPERIOR OBLIQUE TROCHLEAR IV INFERIOR AND LATERAL
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EXTERNAL MUSCULATURE OF THE EYE

• LEVATOR PALPEBRAE SUPERIORIS MUSCLES OPEN THE
  UPPER EYELID
• ORBICULARIS OCULI, A SPHINCTER LIKE MUSCLE, CLOSE
  EYELIDS

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INCUBATION PERIOD FOR STAPHYLOCOCCAL FOOD
POISONING

• 2 TO 4 HOURS

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KRABBES DISEASE

• GLOBOID CELL LEUKODYSTROPHY
• ONSET IN INFANT WITH RIGIDITY
• TERMINAL BLINDNESS
• DEFICIENCY OF BETA GALACTOSIDASE
• ACCUMULATION OF GALACTOCEREBROSIDE.

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COBALT IS AN ESSENTIAL COMPONENT OF

• CYANOCOBOLAMIN B12

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HIRSUTISM ARE ASSOCIATED WITH

• ADRENAL TUMOR
• HYPOTHYROIDISM
• DANAZAL THERAPY
• CYCLOSPORINE THERAPY

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INCREASED IN VMA IS USUALLY SEEN IN

• NEUROBLASTOMA
• PHEOCHROMOCYTOMA

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LANGHERANS CELL HISTIOCYTOSIS CLINICAL FORMS

• LETTER SIWE DISEASE
• HAND SCHBLIER CHRISTIAN DISEASE
• EOSINOPHILIC GRANULOMA
• HASHIMOTO PRITZKER DISEASE

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HISTIOCYTOSIS, LETTERER SIWE DISEASE

• ONSET IN THE FIRST YEAR
• HAVE SEBORRHEIC RASH
• OTITIS MEDIA
• LYMPHADENOPATHY, PURPURA ANEMIA,
• HEPATOSPLENOMEGALY
• EXTENSIVE LYTIC SKULL LESION RAINDROP SKULL
• UNKNOWN ETIOLOGY
• WORST PROGNOSIS

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HISTIOCYTOSIS X

• INTENSE PROLIFERATION OF RETICULOHISTIOCYTIC
  CELLS
• EOSINOPHILIC GRANULOMA
• HAND SCHULLER CHRISTIAN DISEASE
• LETTER SIWE DISEASE

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EOSINOPHILIC GRANULOMA EG -60-80 OF
HISTIOCYTOSIS X -AGE 5-10 YRS MOST COMMON -BEST
PROGNOSISHAND SHULLER-CHRISTIAN DISEASE -AGE
1-3 YRS

• LETTERER SIWE DISEASE
• -AGE 0-1YRS
• -WORST PROGNOSIS MORTALITY 70
• -MALIGNANT FORM OF HISTIOCYTOSIS

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HAND SCHUELLER CHRISTIAN DISEASE

• 1-3 YRS,
• MOST COMMON HISTIOCYTOSIS FORM
• SKULL MANDIBULE LESION SEMILAR EOSINOPHIL
  GRANULOMAS BUT MORE NUMEROUS
• GEOGRAPHIC SKULL FLOATING TEETH
• ADENOPATHY
• HEPATOSPLENOMEGALY
• SKIN LESION
• DIABETES INSIPIDUS
• EXOPHTALMOS
• LUNG DISEASE

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LETTERER SIWE DISEASE SYNONYMS

• ACUTE DIFFUSIBLE HISTIOCYTOSIS
• ACUTE INFANTILE RETICULOENDOTHELIOSIS
• ACUTE RETICULOSIS OF INFANCY
• GENERALIZED HISTIOCYTOSIS
• NON LIPID RETICULOENDOTHELIOSIS

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CURLING ULCER OF THE STOMACH /MARJOLIN OF THE
SKIN ARE CAUSES BY

• BURNS

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CEREBROSPINAL FLUID IN VIRAL ENCEPHALITIS SHOWS

• VARIABLE PLEOCYTOSIS
• DECREASED SUGAR LEVEL
• INCREASED PROTEIN LEVEL

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PRIMARY BILIARY CIRRHOSIS

• MORE COMMON IN WOMEN THAN IN MEN
• ASSOCIATED WITH PRURITUS, JAUNDICE,XANTHOMATOUS
  LESIONS
• INCREASED ALKALINE PHOSPHATASE AND CHOLESTEROL
• MITOCHONDRIAL ANTIBODIES AND INCREASED SERUM IgM.

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SABER SHIN OCCURS MAINLY IN CHILDREN WITH

• CONGENITAL SYPHILIS

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THE MOST COMMON INTRACRANIAL GERM TUMOR

• GERMINOMA

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GERMINOMAS

• HIGHLY RADIOSENSITIVE

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TYPES OF GLIOMAS

• ASTROCYTOMAS
• EPENDYNOMAS
• GANGLIOMAS
• OLIGODENDROGLIOMAS
• MIXED GLIOMAS

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CHILDHOOD GLIOMAS

• ASTROCYTOMAS
• EPENDYMOMAS
• GANGLIOGLIOMAS

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GERM CELL TUMORS CGTs

• GERMINOMAS
• TERATOMAS
• CHORIOCARCINOMAS
• ENDODERMAL SINUS TUMORS
• EMBRYONAL CARCINOMAS
• MIXED GCTs

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PINEAL PARENCHYMAL TUMORS

• PINEOBLASTOMAS
• PINEOCYTOMAS

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PINEAL GLIOMAS

• ASTROCYTOMAS
• EPENDYMOMAS

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PINEAL NEOPLSMS

• 5 OF ALL PEDIATRICS BRAIN TUMORS

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OSGOOD SCHLATTER DISEASE USUALLY OCCURS IN
CHILDREN AGED

• 11 TO 13 YEARS

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OSGOOD SCHLATTER

• OSTEOCHONDROSIS
• PARTIAL AVULSION OF THE TIBIA TUBEROSITY, WITH NO
  INVOLVEMENT OF THE TIBIA PHYSIS
• COMMON CAUSES CAUSES OF KNEE PAIN IN ADOLESCENT
• SWELLING AND TENDERNESS JUST BELOW THE KNEE OVER
  THE SHIN BONE TIBIA
• MORE COMMON IN BOYS
• 8-13 YEARS GIRLS, 10-15 BOYS
• GROWTH SPURT AND MAY AFFECT BOTH KNEES ,
  ENLARGEMENT OF THE TIBIAL TUBERCLE.
• GOES AWAY WITH TIME

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RED SCALY WITH A SHARP RAISED BORDER ON THE
PERINEUM , THIGHS AND BUTTOCKS ARE SEEN IN TINEA

• CRURIS JOCK ITCH

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TINEA CRURIS JOCK ITCH

• ANY ITCHING IN THE GROIN RASH IN MEN
• WHEN CAUSED BY A FUNGUS RASHTINEA CRURIS
• CAUSE OF TINEA CRURIS FUNGUS DERMATOPHYTESRINGWO
  RM FUNGI
• NOT CONTAGIOUS
• BILATERAL
• DO NOT INCLUDE PENIS AND SCROTUM
• MIGRATE TO THE BUTTOCK AND GLUTEAL CLEFT AREA

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DERMATOPHYTES INFECTION IN TINEA CRURI

• MICROSPORUM
• TRICHOPHYTON
• EPIDERMOPHYTON

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THE MOST COMMON CAUSE OF A VIGINITIS IN A 10
YEARS OLD GIRL IS

• FOREIGN BODY

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RETINOBLASTOMA

• MOST COMMON IN LESS THAN 3 YEARS OF AGE
• SHOW WHITE CATS EYES REFLEX ON FUNDOSCOPY
• ARE AUTOSOMAL DOMINANT
• BILATERAL 30 OF CASES
• ARE THE MOST INTRAOCULAR TUMOR IN CHILDREN

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RETINOBLASTOMA

• LEUKOCORIA WHITE PUPIL REFLEX
• STRABISMUS
• EXOTROPIA
• ESOTROPIA
• RED PAINFUL EYE
• POOR VISION , INFLAMMATION TISSUE AROUND THE EYE
• ENLARGED OR DILATATED PUPIL
• HETEROCHROMIA
• FAILURE TO THRIVE
• EXTRA FINGERS OR TOES
• MALFORMED EARS
• RETARDATION

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NOT A CLINICAL FEATURE OF ANOREXIA NERVOSA

• HISTORY OF CHILDHOOD HYPERACTIVITY

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ANOREXIA NERVOSA

• AMENORRHEA
• BRADYCARDIA
• ONSET BEFORE 25 YEARS OF AGE

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CHROMOSOMAL ANALYSIS IS USEFUL IN

• TESTICULAR FEMINIZATION
• GONADAL DYSGENESIS

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(No Transcript)
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DIFFERENTIAL DIAG OF TINEA CRURIS

• INTERTRIGO
• ERYTHRASMA
• SEBORRHEIC DERMATITIS OF THE GROIN
• PSORIASIS OF THE GROIN
• CANDIDIASIS OF THE GROIN

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SINDING LARSEN JOHANSSON SYNDROME

• RESEMBLES OSGOOD SCHLOTTER DISEASE, EXCEPT
  SYMPTOMS LOCALIZED IN THE INFERIOR POLE OF
  PATELLA
• CHRONIC OVERTENSION OF EXTENSOR MECHANISM
• PAIN
• OSSIFICATION DISTURBANCE
• SWELLING
• WEAK QUAD
• REPETITIVE LOADED KNEE FLEXION ACTIVITIES
• LIGAMENT AVULSION
• SOFT TISSUE CALCIFICATION
• STRESS FRACTURE

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OSTEOCHONDROSIS

• LEGG CALVE PERTHES DISEASES CAPITAL FEMORAL
  EPIPHYSIS
• KOHLER DISEASE TARSAL NAVICULAR
• OSGOOD SHLATTER DISEASETIBIAL TUBEROSITY
• SCHEUERMANN DISEASEVERTEBRAL RING EPIPHYSES
• FREIBER INFRACTION METATARSAL HEAD
• SEVER DISEASE APOPHYSIS OF OS CALCIS
• OSTEOCHONDRITIS DISSECANS

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OSTEOCHONDROSIS DISSECANS

• SUBCHONDRAL FATIGUE FRACTURE
• COMMONLY SEEN IN ADOLESCENT
• CAPITELLUM OF THE ELBOW
• KNEE MEDIAL FEMORAL CONDYLE CLOSE TO FOSSA
  INTERCONDYLARIS
• TALUS
• MOUSE OSTEOCHONDROTIC FRAGMENT
• MOUSE BED SCLEROSED PIT IN ARTICULAR SURFACE

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SEVER DISEASE

• OSTEOCHONDROSIS
• APOPHYSIS OF THE OS CALCIS UNDERGOES
  FRAGMENTATION

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FREIBERG INFRACTION

• OSTEOCHONDROSIS
• METATARSAL HEAD
• 2ND COMMON
• 3RD AND 1ST LESS COMMON
• INFARCTION OR STRESS FRACTURE
• LATE ADOLESCENCE
• A END ARTICULAR BECOMES FLATTENED
• SMALL OSSICLES MAY FORM AFTER HEALING
• DJD IS COMMONLY LATE COMPLICATION

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SCHMORL NODE

• CHONDRIFICATION DEFECTS WHERE PERIOSTEAL VESSELS
  PENETRATE CARTILAGE PLATE OF DISC

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KOHLER DISEASE

• OSTEOCHONDROSIS OF TARSAL NAVICULAR

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LEGG CALVE PERTHES DISEASE

• OSTEOCHONDROTIS DEFORMANS
• COXA PLANA
• IDIOPATHIC AVASCULAR NECROSIS OF PROXIMAL FEMORAL
  EPIPHYSIS
• MALE
• UNILATERAL
• 4-8 YRS OLD
• UNCOMMON BEFORE 3Y/O
• SELF LIMITED
• CAN PROGRESS TO COXA PLANA

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MEDIASTINAL ADENOPATHY IS NOT SEEN IN

• IDIOPATHIC PULMONARY FIBROSIS

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MEDIASTINAL ADENOPATHY IS SEEN IN

• SARCOIDOSIS
• MILARY TUBERCULOSIS
• PNEUMOCYSTIS CARNII PNEUMONIA

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ANTERIOR MEDIASTINAL MASSES

• THYMOMA
• TERATOMA
• THYROID ECTOPIC
• LYMPHOMA

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MIDDLE MEDIASTINAL MASSES

• ADENOPATHY INFECTION BACTERIAL, GRANULOMATOUS
• NEOPLASM LEUKEMIA, LYMPHOMA METASTASES
• BRONCHOPULMONARY FOREGUT MALFORMATIONS
• ESOPHAGAL DUPLICATION CYST
• BRONCHOGENIC CYST
• SEQUESTRATION

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POSTERIOR MEDIASTINAL MASSES

• SYMPATHETIC GANGLION TUMORS
• MASSES NEUROBLASTOMA
• GANGLIONEUROBLASTOMA
• GANGLIONEUROMA 95 OF POSTERIOR MEDIASTINAL
  MASSES
• NEUROFIBROMAS
• NEURENTERIC CYST
• EXTRAMEDULLARY HEMATOPOESIS
• PARAVERTEBRAL SOFT TISSUE MASS FROM INFECTION

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BEHAVIOR PSYCHOTHERAPY IS DISTINGUISHED FROM
COGNITIVE PSYCHOTHERAPY BY

• THE VIEW OF BEHAVIOR AS A RESPONSE TO THE
  ENVIRONMENT

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CHILD WITH CIRCULAR AREA OF ALOPECIA THAT ARE
WOODS LAMP POSITIVE

• TINEA CAPITIS
• DUE TO MICROSPORUM CANIS
• TRICHOPHYTON SPECIES
  TOSURANS
• MICROSPORUM SPECIES FLIORESCE A BRIGHT BLUE GREEN
  COLOR
• EPIDERMOPHYTON FLOCCOSUM IS A CAUSE OF TINEA
  CRURIS

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CANDIDA ALBICANS IS RESPONSIBLE FOR

• ORAL RUSH
• DIAPER DERMATITIS IN INFANTS

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MUMPS IS A COMMON CAUSE OF

• VIRAL PAROTITIS

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ASSOCIATED WITH EYE PAIN

• ACUTE ANTERIOR UVEITIS
• OPTIC NEURITIS
• ACUTE GLAUCOMA

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CENTRAL RETINAL VEIN OCCLUSION

• SUDDEN, PAINLESS, UNILATERAL LOSS OF VISION IN
  PATIENTS WITH
• 1/HYPERCOAGULABILITY STATE POLYCUTHEMIA RUBRA
  VERA
• 2/DIABETES MELLITUS
• 3/ GLAUCOMA

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RETINAL EXAM OF CENTRAL RETINAL VEIN OCCLUSION

• SWELLING OF THE OPTIC DISC
• VENOUS DILATATION
• TORTUOSITY
• WIDESPEAD RETINAL HEMORRHAGE
• COTTON WOOD EXUDATE

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HEPARIN

• INCREASES EFFECTIVENESS OF ANTITHROMBIN III

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COUMARIN WARFARIN

• CAUSE THE PLASMA LEVELS OF PROTHROMBINE, FACTORS
  VIII, IX, X TO FALL
• WARFARIN COMPETE WITH VIT K

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AUER ROD

• ACUTE MYELOCYTIC LEUKEMIA

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REED STENDBERG CELLS

• HODGKINS DISEASE MIXED CELLULARITY

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ERB DUCHENNE PALSY

• INJURY TO C-5 AND C-6

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NEUROBLASTOMA

• THE MOST COMMON LOCATION
• ABDOMEN

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NEUROBLASTOMA

• IT ACCOUNT FOR 15 OF ALL CHILDHOOD CANCER DEATH
• 35 OF CASES APPEAR DURING THE FIRST YEAR OF LIFE
• IT IS ONE OF THE MOST COMMON CHILDHOOD
  EXTRACRANIAL SOLID CANCER

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CHILDREN WITH NEUROBLASTOMA THE MOST COMMON
CONGENITAL TUMOR OCCURING DURING THE FIRST YEAR
OF LIFE USUALLY PRESENT

• PALPABLE ABDOMINAL MASS

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THE MOST COMMON SOLID MALIGNANT TUMOR IN CHILDREN
UNDER THE AGE OF 4 YEARS IS

• NEUROBLASTOMA

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PHEOCHROMOCYTOMA AND NEUROBLASTOMA ARE ASSOCIATED
WITH INCREASED URINARY

• VANILLYLMANDELIC ACID VMA

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IN PATIENT WITH NEUROBLASTOMA , THE INCIDENCE OF
METASTASES AT TIME OF INITIAL DIAGNOSIS IS

• 70

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SCREENING FOR NEUROBLASTOMA IS MADE BY VMA AND
HVA HOMOVANILLIC ACID
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THE MOST PRIMARY SITE OF NEUROBLASTOMA IS

• ADRENAL GLAND

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IN NEUROBLASTOMA, CALCIFICATION IS PRESENT IN

• 45

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SPLENOMEGALY IS NOT A CHARACTERISTIC FEATURE OF

• NEUROBLASTOMA

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SPLENOMEGALY CHARACTERISTICS OF

• GALACTOSEMIA
• CYSTINOSIS
• PORPHYRIA
• GAUCHERS DISEASE

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NEUROBLASTOMA IS ASSOCIATED WITH

• SPONTANEOUS REGRESSION

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THE INFANT OF A DIABETIC MOTHER COMMONLY DEVELOPS

• HYPOGLYCEMIA
• HYPERBILIRUBINEMIA
• HYPOCALCEMIA
• POLYCYTHEMIA
• INCREASED INCIDENCE OF CONGENITAL MALFORMATION
  HEART AND SQUELETTAL DEFECT

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ASSOCIATION OF HORNERS SYNDROME WITH A NECK MASS
IN CHILREN IS MOST LIKELYDUE TO

• NEUROBLASTOMA

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A CHILD WITH A POSTERIOR MEDIASTINAL MASS THE
MOST LIKELY DIAGNOSIS IS

• NEUROBLASTOMA

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MEGALOBLASTIC ANEMIA
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OCCUR DURING NORMAL GROWTH IN THE FIRST 12 MONTHS
OF LIFE

• AT LEAST A DOUBLING OF THE INITIAL BIRTH WEIGHT
• TRIPLE THEIR WEIGHT BY 12 MONTHS
• CLOSURE OF THE POSTERIOR FONTANELLE 2-4 MONTHS
• ANTERIOR FONTANELLE CLOSES AT 6-18 MONTHS
• ERUPTION OF AN AVERAGE OF 6-8 DECIDUOUS TEETH
• INCREASE IN LENGTH OF 25 30 CM

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TODDLER 24 MONTHS CAN

• LINK 3-4 WORDS TOGETHER IN SIMPLE SENTENCES
• ASSIST IN UNDRESSING SELF
• HANDLE SPOON AND CUP WELL
• BUILD A TOWER OF A 5-6 CUBES

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HEMOPHILUS INFLUENZAE B

• UNDER 2YRS OLD
• MENINGITIS
• SEPTIC ARTHRITIS
• BUCCAL CELLULITIS
• OLDER CHILD
• EPIGLOTTITIS
• PNEUMONIAE

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HEMOPHILUS INFLUENZAE B

• SEPTIC ARTHRITIS IN A 4 MONTH OLD INFANT
• MENINGITIS IN A 3 YRS OLD CHILD
• EPIGLOTTITIS IN A 6 YRS OLD CHILD
• BUCCAL CELLULITIS IN A 15 MONTH OLD INFANT.

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PNEUMOCOCCAL SEPSIS IS A DITINCT POSSIBILITY IN
PATIENTS WITH THE FOLLOWING UNDERLYING DISEASES

• PATIENT WITH ASPLENIA
• 10 YRS OLD WITH SICKLE CELL ANEMIA
• 5YR OLD SURVIVOR OF HODGKINS DISEASE FOLLOWING
  SPLENECTOMY
• 8 YRS OLD WITH CHRONIC GRANULOMATOUS DISEASE

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ESOPHAGEAL ATRESIA

• Excessive secretions noted in the new born
  nursery
• Difficulty feeding with cyanotic episode
• Inability to pass a catheter into the stomach
• A history of polyhydramnios
• Commonly associated with tracheoesophageal
  fistula

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OTITIS MEDIA COMPLICATION

• Hearing loss
• Brain abscess formation, meningitis, focal
  encephalitis.
• Cholesteatoma
• Facial nerve paralysis
• Perforation of tympanic membrane

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Otitis media

• S. pneumoniae , H.influtenzae are the most
  common causative agents
• Most prevalence infectious diseases in the
  childhood.

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(No Transcript)
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Congenital hypothyroidism

• Newborn screening programs have been initiated in
  most states due to the difficulty in identifying
  the affected children
• Delay in therapeutic can lead to brain damage
• Premature infants frequently have transiently low
  levels of thyrotropin releasing factor
• The breast fed infants with hypothyroidism is
  partially protected due to the presence of
  maternal thyroid hormone in the milk
• Normal birth weight , length , head circumference

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The most common type of seizure seen in the new
born period is

• Subtle seizures eye deviations,sucking,
  posturing with the extremities

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Most common manifestation of acute valvular
disease during the initial stages of rheumatic
fever

• Mitral regurgitation
• Tachycardia
• Cardiomegaly
• Pericardial effusion
• Complication later valvular stenosis

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Normal hematologic values in the full term infant

• Polycythemia with a normal hb of 16-18 and hct of
  45-60
• HT and HB relatively high declining by 7 weeks of
  age for premature and 2- 3 months for for the
  term infant physiologic anemia in infancy.
• Predominance of fetal hemoglobin
• Mcv mean corpuscular volume high during neonatal
  period but declines during the later infancy.
• Normal white blood cell count ranging from 5000
  to 30000 in the first 48h after birth with a
  granulocytes predominance
• Midly prolonged prothrombin time PT and PTT

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New born anemia

• Hemolytic diseases
• Acute blood loss
• Chronic blood loss
• Impaired red blood cell production

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New born anemia etiology

• I/ hemolytic disease of the new born
  erythroblastosis fetalis
• Blood group incompatibility