Checklist for pediatric history

1. Patient’s ID
a. Name:
b. Age & date of birth:
c. Gender:
d. Religion:
e. Nationality:
f. Address:
g. Date of admission:
h. Mode of referral:
i. Source of information:
----------------------------------------------------------------------------------------------
2. Chief complaint and duration:

-----------------------------------------------------------------------------------------------
3. History of present illness
Dryhistory chronic use
DrugAnergy

1|Page
 4. Systemic review
a. General
 Appetite:
 Weight loss & amount:
 Fatigue:
 Daily activities:
 Sleep problems:
 School absence:
 Fever:
 Rigor:

b. Cardiopulmonary
 Chest pain (with descriptions):
 Palpitation:
 Cyanosis
 Loss of consciousness
 Body swelling

c. Difficulty in breathing:
 Cough:
 Sputum:
 Hemoptysis:
 Stridor: mouthbreathing
 Wheezing:
 Snoring:
 Cyanosis

d. Gastrointestinal
 Appetite:
 Weight loss/gain: Vomiting conts Askabout
 Abdominal pian: abd distent
 Bowel habit:
 Stool: Jaundice
 Nausea:
 Vomiting:
 Hematemesis:
 Melena:
 Hematochezia:
 Abdominal pain:
 Abdominal distension:
 Jaundice:

2|Page
 e. Nervous
 Higher centers
 TLOC or fainting:
 Speech problems:
 Hearing:
 Smelling:
 Fits:
 Abnormal movements:
 Tremor:
 Cranial nerves
 Smell:
 Vision:
 Facial asymmetry:
 Vertigo and dizziness:
 Nasal regurgitation:
 Raised ICP:
 Projectile vomiting:
 Blurred vision:
 Headache:

f. Renal
L  Dysuria:
Ebdpain  Urine
 Frequency
color
amount  Volume:
I
 Character of urine stream:
 Color:
 Bloody:
 Odor:
 Hematuria:
 Edema:
 Discharge
 Bedwetting:

g. Endocrine
 Heat/cold intolerance:
 Neck swelling:
 Fatigue:
 Change in weight:
 Polyuria:
 Polydipsia:
 Abdominal pain:
 Change in shoe’s size:

3|Page
 h. Hematological
 Bleeding tendency:
 Bruising:
 Melena:
 Hematemesis:
 Epistaxis:
 Bleeding spots:
 Joint swelling
 Lymphadenopathy:
 Fatigue:
 Palpitation:
 Headache:

i. Musculoskeletal
 Joint pain: 0 ha
 Joint swelling:
 Joint stiffness:
I
 Gait abnormalities:
 Sore eyes:
 Dry mouth:

j. Mucocutaneous
 Hair loss:
 Rash: I macho ane
 Itching:
 Discoloration:
 Mouth ulcers:
 Epistaxis:
 Swelling:

k. Gynecological and obstetrical (not always)

 Menstrual cycle:
 Regularity:
 Amount:

4|Page
 5. Past history
a. Prenatal:
 Maternal age:
 Planned pregnancy?
 Maternal disease
 DM
 Preeclampsia
 Anemia
 Thyroid
 Maternal infection (fever, rash):
 Maternal bleeding:
 Maternal stress:
 Maternal hospital admission:
 Maternal drug use:
 Maternal vaccination (tetanus):
 Maternal irradiation:
 Maternal nutrition:
 History of medical or psychiatric disease:
 History of incompatibility (Rh):
 History of infertility:
 History of previous abortions:
 History of previous fetal deaths:

b. Natal:
 Mode of delivery:
 If cesarian, indication:
 Presentation of fetus:
 Duration of labor:
 Assisted delivery:
 Gestational age:
 Prolonged ROM:
 Birth asphyxia:
 Any fetal complications:

c. Postnatal:
 NCU admission and duration:
 Baby cry:
 Weight:
 Umbilical cord:
 Initiation of breast feeding:
 Meconium:
 Urine:
 Vaccination:

5|Page
 pf
Name of theDrug
 Vitamin K prophylaxis:
 Fetal complications: pg
 Jaundice:
vaccines In
 Seizures: after
 RDS: Idadoneanycomp
 Birth injuries: feverrash
hematoma in
siteofinfection
d. Past medical:
 Previous similar conditions:
NG change noindays
 Associated diseases (autoimmune):
boot infectionrise
 Chronic disease:
 Previous infection:
 Measles:
 Mumps:
 Diphtheria:
 Tetanus:
 Pertussis:
 Chicken pox:
 Hospitalization:

e. Past surgical:
 Previous surgery:
 Previous blood transfusion:
 Previous procedure (e.g.) lumbar puncture:
f. Drug history
 Drug allergy (penicillin, sulfa drugs):
 History of allergic reaction (drug and symptoms):
 Alternative / herbal therapy:
Brand Scientific Form / Dose Frequency Duration Indication
name name Route

6|Page
 6. Feeding history:
a. If infant:
 Breastfeeding
 Exclusive or not:
 Frequency (even at night):
 On need or scheduled:
 Duration:
 Technique:
 Baby sleep after meal:
 Any regurgitation or vomiting:
 Passing stool:
 Passing urine:
 Supplements:
 Bottle feeding:
 Exclusive or not:
 Frequency (even at night):
 On need or scheduled:
 Ounces per meal:
 Preparation:
 Sterilization:
 Type of formula:
 Baby sleep after meal:
 Any regurgitation or vomiting:
 Passing stool:
 Passing urine:
 Supplements:
 Weaning:
 At what age:
 Types of weaning food:
 What food administered:
 Amount:
 Change in bowel habit:
 Baby cry:
 Rash:
 Supplements:
b. If older children:
 Food intake 24hr before consultation:
 Number of meals:
 Composition:
 Food allergy:
 Eating non edible things:
 Supplements:

7|Page
 7. Vaccination history
a. Is the vaccination schedule completed?
b. Last received vaccine and time:

Age Vaccine Route Administered or

not
24hrs after birth BCG Oral
OPV IM (thigh)
HepB IM (left deltoid)
2 months DTP + HiB + HepB IM (thigh)
OPV Oral
RV Oral
Pneumococcal IM
4 months DTP + HiB IM (thigh)
OPV Oral
RV Oral
Pneumococcal IM
6 months DTP + HiB + HepB IM (thigh)
OPV Oral
RV Oral
Pneumococcal IM
9 months Measles SC (shoulder)
Vitamin A 100,000 IU Oral
15 months MMR SC (shoulder)
18 months DTP + HiB + HepB (booster1) IM (thigh)
OPV (booster1) Oral
Vitamin A 200,000IU Oral
4-6 years DTP + HiB (booster2) IM (thigh)
OPV (booster2) Oral
MMR SC
Vitamin A 200,000IU Oral

8|Page
 8. Developmental history

Age Gross motor Fine motor & Speech & Social

vision language

-------------------------------------------------------------------------------------------------------
9. Family history
a. Mother and father
 Age
 Health
 Consanguinity
 Chronic disease
 Hereditary disease
 Similar complaints
b. Siblings
 Age
 Health
 Order of patient
 Chronic disease
 Hereditary disease
 Inborn error of metabolism
 Diseases associated with patients’ condition (e.g., autoimmune)
 Infections (e.g., gastroenteritis)
 Similar complaints

9|Page
 ao
10. Social history
a. Patents are smokers:
b. Housing:
 Number of rooms
 Number of family members living together
 Sanitation
 Water supply
c. Animal contact:
d. Trans-sea travel:

10 | P a g e
 euprell ese
generalized focal tonic clonic Lose of condos

Duration of fit
aesomerating factors misdose of dry fever BWP
relieving factors 11
b in

control sphincter 4years if the pt had control

how long still unconscious after fit relived
Ivor rectal dian if not respon I timey
other nervous system big finishing
id fit in Git
A Yw
association symptoms vomiting Icp A

febrile convo y 6 month 6 year not recurrent

CI weak Muscle impaired swath MG tube

n
Drug Route Better or not
O
 ‫ وسام‬.‫د‬

Fever types
continous
intermittent (‫)ترجع للبيز(ين بعدين تصعد‬
Remittent(‫)تنزل بس مترجع للنورمل‬
Relapsing and others

Tympanic mm temperature ‫ شهور ي> اكدر اقيسله‬٦ ‫وره‬

! Decrease fever by
1- paracetamol ( reduce fever to normal body temperture)
2-NSAID
But don’t use it in pediatric because it increase creatnine also reduce fever
Below normal temp so there is risk of hypothermia and cause gastritis and
peptic ulcer must be taken on full stomach

If patient have epilepsy must ask controlled or not

! Fever + seizure
1. Febrile seizure
2. Meningitis encephalotis
3. Electrolytes distrubnace
4.hypoglycemia

! Febrile seizure
Last less than 15 minutes
Never occur twice in 24 hrs
Generalized tonic clonic but can be focal
! Normal amount of urine is (1-6) cc
Oligouria(0.5-1)
Polyuria more than 6 cc/ kg
Anuria < 0.5 cc/ kg

Hematuria 5 ‫ اكثر من‬rbc

! Glomerulonephrotis and hemolysis ( g6pd) cause dark color urine or

cola colored
! Blood urine(bleeding tendency, trauma ,tumor,stone,uti,food beet)
cyclophospmaide(hemorrhagic cystitis if fluid given in small quantities )
Rifampin orange color urine

Each fever ask about jaundice(hepatitis)

Fever, abdominal pain, dark color urine(‫)مرات هذا يصير قبل ليصير الجوندس‬

! papulomacular rash(measles)(fever and rash at same time) also can be

meningococcemia
! But if fever disappeared and macuolopapular rash appears think of
roseola infantum
Important to ask about jaundice in patient with fit and developmental
delay(kernicterus)

‫ اكتب ا&دكيشن‬drug hx ‫ وبال‬on medication ‫ن مرض‬2‫ بف‬diagnosed ‫اكدر اكتب‬

! Salbutamol (ventolin) it is inhaler

! Pulmicort (‫ ( هاي اقراص للتبخير )بي ستيرويد‬neublized )

‫ن اذا حليب اول القراءه تطلع غلط‬4 fit ‫طريقه تحضير الحليب مي ثم حليب وهذا مهم اساله بابو‬
‫ الخ‬fit ‫ وهالشي يدخله ب‬hypo or hyper natremia ‫وممكن يصير‬

! Why Bcg left deltoid? ‫ علمود راسا يعرفوا‬bcg ‫مو غير لقاح‬
Hepatitis right thigh
 oral polio or live attenuated ‫ اسبوع ي( اكدر انطي‬٨-٦ ‫ وره‬steroid ‫الي ياخذ‬
‫ عادي باي وقت‬killed ‫ بس‬vaccine

‫ واسال على‬epilepsy and developmental delay ‫ مهم بكيس‬consanguinty ‫زم الفاملي اسال‬5
parent and brothers

Asthma ‫ اسال‬alopecia vitiligo atopic dermatitis atopy food allergy and drug allergy
and autoimmune diseases like thyroid,d،،‫ حتى لو الكيس هستري اوف‬asthma ‫وجاي بغير‬
complain ‫جاتها ب‬C‫مراض( واكتب ع‬5‫ اسال ع هاي ا‬drug history

! Cp are hypotonic so most commonly liable for aspiration pneumonia

Whole blood is 20 cc per kg

Packed rbc is 10 cc per kg
Plasma is 15 cc per kg
Platelet and cryopercipitate(1)unit per 5 kg

cyanosis pallor jaundice ‫ا&لونات‬

lap ,edema ‫ا&نتفخات‬

hydrocephalus ‫ و‬familial ‫اسباب كبر حجم الراس‬

peripheral in cold weather ‫طفال هو‬:‫ با‬cyanosis ‫اهم سبب‬

Causes of cyanosis
cyanotic CHD 5 T
respirator distress ending in failure، severe pneumonia if ends in
respiratory failure )
 (artificial eye ‫ وحده جوندس)مضروب ع عينه او‬3‫اذا ع‬

Axillary lap
‫يد الخ‬8‫صافح ا?ريض وافحص با‬

(cervical axillary epitrochlear inguinal popliteal) ‫اللمف نود‬

If child taking supplement ask why

! Delay closure of fontanells in Ricketts,hypothyroidism and Renal failure

(‫ذن‬#‫)وره ا‬shunt ‫من اشوف الراس كبير ادور ع‬

! When giving vit d to rickets and see response
the cupping and fraying replaced by white line

! Salaam Seizures (focal fit )

‫بضبط مثل واحد يسلم‬

! Weight gain
In 4-5 months double weight
1y triple weight
2y quadriple weight

! Ng theraputic
Giving feeding , medicine
Decompression in intestinal obstruction

" Hyperextended Neck on exam

Cp from asphaxia , kernectrus
tonsillitis ‫ن هي السرفايكل تكبر من‬1 ‫ بالجسم‬LN ‫ انزل اجيك باقي‬cervical lap ‫من اشوف‬
and otitis media

Only 10 days child with intestinal aresia and colostomy first ddx
Hirschsprung disease

Site for bonemarrow biobsy below one

year
Cannula in scalp veins
Older children from iliac crest

Complication of prolonged
cpap causin pressure necrosis
Prednisolone syrup 5 cc =15 mg, Each 1 cc 3 mg
And there is 5 cc = 5 mg
Tab 5mg =20 mg

! First 3 months congenital nephrotic

Infantile 1-3
Idiopathic1 -12 year

! Urgency: have desire and want to urinate but no urine

! Relapse in nephrotic what to send

Gue cbc albumin rft cholestrol

! Renal failure in nephrotic syndrome

Hypovolemia
Bilateral Rv thrombosis
Sepsis
Atn prolonged hypotention
Acute interstitial nephritis from drugs
-Lasix
-Omperazole
-Ganamycin antibiotics
Post renal large stone

! Albumin indication generalized edma pleural effusion

Scrotal swelling alone is indication by itself

! In shock with nephrotic wegive albumin bec ns will increase edema

 ! Plasma can be given but increase risk of anaphylactic reaction and future
hepatitis

! Mechanism for thromboemboilsm

Dehydration
Hypercholestrolemia
Thrombocytosis from steroids
Loss protein C, Sin urine
Antithrombin low
Hight fibrinogen

! There is primary and secondary vur

Primary problem in valve no need for foly cath. We do reimplantation surgery
‫ با(ثانه وبس‬ureter‫هيج يجون يغيرون مكان ال‬
Secondary vur due to neurogenic bladder or puv
Those need foly

! Fit and electrolyte in nephrotic

Hypocalcemia because it is bound to albumin
While hyponatremia doesnt cause because in nephrotic it is delusional

! In ros mention the musculoskeletal system

Gait imp
Proximal myopathy from steriod or avs diagnosed by mri

Ask about rash possible infection

Past medical focus on hospital admisison importany for relapse numbers

! Hiv cause focl segmental
Heb b membrenous blood ‫فمهم اسال على‬
C menrenoproliferative transfusiosn

Non hodking cause secondary nephrotic

‫وهاي تتعالج من اعالج السبب متبقه‬
! Feeding
Fluids only during replapse
Salts
Red meat once weekly increase blood acidity and inrease risk of stone

! Patient with hydrocephalus and shunt

You should examine back for previous meyloneigycele
neurogenic bladder ‫يجون عدهم‬
No sphincter control
Lower limbs weakness and parLysis

! Double lumen can be in neck or femur for hemodialysis

Central line for antibiotics

translumbar ‫بس هنا خاليله‬

double lumen
! Ckd means when gfr below 60 for 3 months
Esdr gfr below gfr 15

! Congeintal nephrotic associate with congenital hypothyroidism

Usually bad prognsosis
Dont make it live max. To 4 years
Usually die from sepsis
They need kideny transplant
‫ سنه‬١٨‫ عادة فوك ال‬donor adult‫نه ا‬0 ‫عادة هنا ماكو‬
‫ يله اكدر انقل‬٢٠‫زم وزن الجسم‬0

! So we do medical nephrectomy by giving ace inhibitors and

endomethacin to decrease renal perfusion and decrease gfr
‫ حتصعد عدهم‬urea ‫لكن‬
 There is intermittent and continous peritoneal dialysis
‫يدات‬%‫كال نجيبها با*وسكي او س‬

Intermittent In acute settings

Toxins Chronic renal failure
Hypertensive and uremic
encephalopathy
Hus
Acute renal failure

Scar below umbillicus Scar ‫اطول‬

Tunnel ‫مثل‬

Rigid cath

Coiled cath ‫ينطوي‬

4
Dr Wissam 202318122

Pertuises WBC is mor than 20,00078

A case About Joint Pain

in Pain and limitation Always Ask By
t or to Fa tors like movement
Right shoulder reeffved Pain is
mostly
from cholesaltic
realived rest not or dru
By
or

Cold spongie colling Pads

in history of fever Always Ask About

ABM
Always Assess The severity of Pain By
yes W 275
saying
Are mostly more
Ba why Pain fever Sob
At night
cortisol At night
Due to an
 Hb less to
PLT les 20,100 Are
Abnormal
WBL less
47000

Always make The Ros after HOPI

not at The End
Brain's's's p s's
SIE
a.m y
i
si en zur
lukopenic nephritis
lumphopen nephrotic
ticanemahepstini
Defintive
By Pip
mayhaveHSM
J
y
if Pt in SLE has Rf still
give him Drugs
Joint Arthritis without destruct
SLE
RA There is deformity
Ask Fx celiac Thyroid
 more than 12kg we can do
hemodylisis

icon
other
folly
Ingerperis
no Allerny

f t
intermen
Perouting
All
hyperkalemia

Effinwait
tinsman
2 Weeks
 ~

prophylactic
* Vitamine y -> Ime as sits by
*

for vitaminek
Treatment -> 5 my

Away offeeding
4-4505 is xwhole bod - zopernig
mechanical GERD. :0 Plasma
* -> 1S
*
Platelete ->
Junit per 5

DarkColor
* urine -> Hepatitis A Packeel RBCs 5 Pediatric 3! s's
Hemolysis 8.50
hypervolemias is whole brood. Se

Reel
* color urine -> Trauma
Stone Stage ofchronic kidney failure
tumor -

Stage 1. GFR790
Drugs: Cyclosporins - Stage 2: GFR 60-90
-
stage 3A: GFR 45-60
CPAP complication
* in
eye ->Retina Pathy ofprematurity -
Stage 3B: GAR 30 - 45

follow up issis -

Stage 4. GFR 15130

- end stay. GAR lessthan 15

chronic kidney failure 3months, CfR

-

* -> 760 Iransplants) Dialysis 2.51,

Erigination
·is

Ij:Ih
aresis
jaundice

edenes
renel
Lin
-
Renal

rat
failure

Renc
-->

lymphadenopathy ⑱
-> GN
purpure Hypovolemia Bilateral large
acute tubular
Dehydration Shock Sizevenal stone
-Signs of-> Dehydration necrosis
thatcase

De
-Seinei Obstruction

-
Vital Signs
-growth parameter

Indications
*

for dialysis
-

-
Acidosis not responding to medical treatment
-
uncontrolled Hypertension due to renal cause

-
uremic encephalopathy
-
Hypercalemia not responding to meetiful treatment
- fluid overload not responding to meditation

&-
Endotracheal tube -
-

-Ds?I
Mechanical Ventilator
 SHARP
Stage
↓ b x
- ->
managmentofread failure
-> Plan
-
either conservative

offailure -
Mertension Anemia proteinuria
udjusments
of
or Renal Transplant

from 1- 5 and Drug

Is Acidosis Iper
m2
in
.
↓
R
⑯
Alo
pregnancy
-
nephrotic range
GFR Height x constant (k)
=

(CI: PARK)
a
Ace inhibitor proteinuria K in preterm ml per minute
-

-
3
Angioedemen * 0.33
=

Hyperkalemia
-
B blocker (CI:Asthman) Bilateral vener A. K
*
in term 0.45 ml per minute
=

stenosis
- CCB (i. edema) * from 1 year to 12
years 0.55
=

Dialysis (CI:Hypokalemia) more than layers 0.7

male:
*
-

more than 12 years

*

female 0.5
=

*
hyperphosphatemia - Diet is
mik and i
milk product

*
Hyperkalemia -> In ECG 5 tented wave
Fron
*Anemia -
-> folic acid
↓ biz
ofInfection
treatment

Acidosis
* -
Sodium Bicarbonate

in urine
analysis - Specific gravity 10.035 -

diabetes incipids !low? Is

*posterior fontanel closes at

months
*

Anterior fontand closes 9 month ->18 month

DVT
edemes
A non
pitting in ->
lymphatic Obstruction
Cellulitis
 ~

prophylactic
* Vitamine y -> Ime as sits by
*

for vitaminek
Treatment -> 5 my

Away offeeding
4-4505 is xwhole bod - zopernig
mechanical GERD. :0 Plasma
* -> 1S
*
Platelete ->
Junit per 5

DarkColor
* urine -> Hepatitis A Packeel RBCs 5 Pediatric 3! s's
Hemolysis 8.50
hypervolemias is whole brood. Se

Reel
* color urine -> Trauma
Stone Stage ofchronic kidney failure
tumor -

Stage 1. GFR790
Drugs: Cyclosporins - Stage 2: GFR 60-90
-
stage 3A: GFR 45-60
CPAP complication
* in
eye ->Retina Pathy ofprematurity -
Stage 3B: GAR 30 - 45

follow up issis -

Stage 4. GFR 15130

- end stay. GAR lessthan 15

chronic kidney failure 3months, CfR

-

* -> 760 Iransplants) Dialysis 2.51,

Erigination
·is

Ij:Ih
aresis
jaundice

edenes
renel
Lin
-
Renal

rat
failure

Renc
-->

lymphadenopathy ⑱
-> GN
purpure Hypovolemia Bilateral large
acute tubular
Dehydration Shock Sizevenal stone
-Signs of-> Dehydration necrosis
thatcase

De
-Seinei Obstruction

-
Vital Signs
-growth parameter

Indications
*

for dialysis
-

-
Acidosis not responding to medical treatment
-
uncontrolled Hypertension due to renal cause

-
uremic encephalopathy
-
Hypercalemia not responding to meetiful treatment
- fluid overload not responding to meditation

&-
Endotracheal tube -
-

-Ds?I
Mechanical Ventilator
 SHARP
Stage
↓ b x
- ->
managmentofread failure
-> Plan
-
either conservative

offailure -
Mertension Anemia proteinuria
udjusments
of
or Renal Transplant

from 1- 5 and Drug

Is Acidosis Iper
m2
in
.
↓
R
⑯
Alo
pregnancy
-
nephrotic range
GFR Height x constant (k)
=

(CI: PARK)
a
Ace inhibitor proteinuria K in preterm ml per minute
-

-
3
Angioedemen * 0.33
=

Hyperkalemia
-
B blocker (CI:Asthman) Bilateral vener A. K
*
in term 0.45 ml per minute
=

stenosis
- CCB (i. edema) * from 1 year to 12
years 0.55
=

Dialysis (CI:Hypokalemia) more than layers 0.7

male:
*
-

more than 12 years

*

female 0.5
=

*
hyperphosphatemia - Diet is
mik and i
milk product

*
Hyperkalemia -> In ECG 5 tented wave
Fron
*Anemia -
-> folic acid
↓ biz
ofInfection
treatment

Acidosis
* -
Sodium Bicarbonate

in urine
analysis - Specific gravity 10.035 -

diabetes incipids !low? Is

*posterior fontanel closes at

months
*

Anterior fontand closes 9 month ->18 month

DVT
edemes
A non
pitting in ->
lymphatic Obstruction
Cellulitis
Dose
*
paracetamete(-15mePerky
of
Tevery every
stas

Thus ours

paracetamole (safer)
antipyretics
* -

>YNSAIDS es,5 Decrease temprature below normal (hypothermia)

profine
ulcerations, 5
Gastvitis

from month to byears

febrile
* seizure e

3 seizures(focals)
generalised
In complex type. Recurrence
fitatEi
didnt
DDX
- i

-
ABC meningitis, encephalitis
-V
-

Diazepam a Intree cranial hemorrhage

Rectally
-
-

&
0.15-0.2 -
feb vile seizure
my per
kg -
electrolyte Imbalance
- 1930,IS& -
-

hypoglycemic
bic 15
-
Phenobarbital
Stridor 15% 1:
=> I
↑

Paracetamole
-

- Abnormal breathing sound -5

- Random blood sugar check
-electrolyte (Nu +(u)

A non purulent
congenetivitis -> In meuseles
65. fere is Rashsy,
Kawasakiacrucked
lips -

* roseolle -
& II
-

Strawberry tongue
Symphadenopathy most common
ki loh
E
ESR +
complication
ofRash the body involving month dontic =>
DDX all over
anayrism 0o53
Rupture,51,
and tongue: -

Sudden death
-

Kawasaki
-

sulfe
- Steren junksen - Due to drug methprin
3
..I third generation
...

good cover ofantibiotics

bantipeyritia drug cephalosporins
and hydration ?sgs1*
Bleeding tendency isINR, DTT, PT

Thrombocytopness Plectable sis's

LBC

ast sugar is blood sugar.

2. Openfontunnel (i), Papilledere is fundoscopy
654g
Generaliscel swelling periorbital
e

abotominal swelling
S
edemen
genital swelling
generalisal swelling
⑯ A
frequency sie s, *

-
nephrotic Syndrome isof d
Diappers,
- Reneel failure clue to hypovolemic Shock) sworkedwith iss
-
Cardiac fause urine

-
Liver sense extra diapers
- nutritional (poor oral intake) urine
2.s' s
side -

- protein losing through GIT

enterophertly -815555.1
-

Bleeding Tendeng Skene Petichine

-

in
- with pressure
ecchymosis -> Disappear
&
-
s.s Purpura J

#:1551? jiheuring siglogs;*

sheaving signs i
fever Photophobia
-

* -
Meningitis-
-complication ofmeningitis

hypertension during pregnancy

* FUGR ->
-
utitis medic
DM during pregnancy
* Mactesomnia
->

fever trash
x
- Meningococceric

measels - Supportive
treatment + Vit. A
200,000 for
unit Idys

· . .
contraindication to vaccination: -
Iron dieffiency anemic
-previouse allergy or complication -
Vitamin D
Dieffiency
to the same vaccine -
hypo Calemic
- Immunocompromised patient -ww weight. sg. 2.
- Active infection

-
whole blood ->
Zong perky
-
Packed RBCs -> long per
my
-
Plasma -> 15mg perky
-cryotherapy ->
Junit for
every 5kg

Salbutamol -
nubilizen-
-
? is
Steroids
S
normal saline E
Epinephrine (Incroup)
uses
- Asthma, croup

schemes,jaunelice sits is
Skin d

mucouse membrane ofmouth

*
Pulling ofskin i
S

tres, fingers Is Jein Kawasaki

In Steven joulsen
*

-dis

- X's?:0e 5.6881, s
S
-

<50 als!; , gos

S -

15-
-
35 100 =

*
Causes ofhypotonic:
-
hypothyroidism
-
Down syndrome
- CD
- muscular
dystrophy
back
I's 300 hypotonia
weakness, is k *
Single lymph node
meningomylocele o's"'s sweling fever DDX+

Malignancy
- local infection
-
TB
microdrip -
connective tissue (SLE)

e every 15 drop
drop 1x6-
g,s
60 ->

&s
1x 6>

for
Decompression
*NasuGastric tube uses. Susspecion ofIntestinal
obstruction

. for feed is e

Brain damage
/

, is 201 J. s
&
- i *CMV - ss', asis
- obstructive labor
-Birth Asphexia Hypertricosis
x -> abnormal hair growing in abnormal
-
Jaunelice (kernucterus) Site

-
NU admission ·xdneutrophils - CSFJ?1s X
--

meningitis -
color-sited in hemorrhage
-

Cs)

Turboid in bacterial infection

yellow in Jaunelice
contrainelication to neck

A lower limb weakness stiffness examination:

- i
-
Down syndrome - -

-GBD (Ascendling paralysis) cutluntoaxial subluxation)

joint

C4
-
neck injury
Scephtriaxone
-

Steroid
-
cause proximal
myopathy + Zoprax
lacyclovir)
+Vancomycin