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Peds

Aniridia is the absence of the iris, usually involving both eyes. It can be congenital or caused by a penetrant injury. Isolated aniridia is a congenital disorder which is not limited to a defect in iris development, but is a panocular condition with macular and optic nerve hypoplasia, cataract, and corneal changes. -Children are 20/20 in vision only when they are 6 years old.

-X-ray can be done to check for growth in those worried about being short

-2 month old:

*97.6 T

*11.7 Lbs

* 24 3/4 height

-15 diapers/day (1 poop a day-mucous/blood..any allergies that mom may be consuming?)

-Nurses 4 times a day (2 hrs each time) MD Baez recommends nursing for 30 min at a time 

-Baby taking vit D

-2 mo f/u after this visit

- Aniridia is the absence of the iris, usually involving both eyes. It can be congenital or caused by a penetrant injury. Isolated aniridia is a congenital disorder which is not limited to a defect in iris development, but is a panocular condition with macular and optic nerve hypoplasia, cataract, and corneal changes.

*spontaneous mutation

*can pass to child

*PX6 gene affected

*Check for Wilms tumor (sonogram)-kidneys

*Ck for MR

*nystagmus

*Risk: glaucoma

*Red reflex? you can see a lot of red when looking into pts eyes bec pupils are so dilated

-Gas X for gas

-Colic: bend babys knees

-In babies 1-6 mo: they grow 0.5 ounce a day

-4 ounces q 3hrs is appropriate 

-RSV-premie/cardiac pts????

-whey

casin 

-croup:

hoarse, seal like cough, adults gets laryngitis, babies get croup, at night..it is worse..baby chokes on phlegm, steam bath/cold air/saline drops into nose help. Will turn into a regular cough. Rx: presnoisolone  PO and vicks helps. IM  presnoisolone for those with stridor. NO honey!

-Inflammed eosinophillic cells via endoscopy due to food allergies: 

*budesonide PO

*Nexium

-Neocate Splash-hypoallergenic amino acids in juice form

*Eosinophilic esophagitis

*Food protein-induced enterocolitis syndromeShort bowel syndrome Malabsorption Gastroesophageal reflux

-Elecare:

*EleCare and EleCare Jr are:Hypoallergenic1,* - Virtually eliminating the potential for an allergic reaction to the formula in multiple-food-allergic children100% free amino acids as the protein sourceClinically shown to be well-tolerated1,2,*in infants and children who cannot tolerate intact or hydrolyzed protein

-pediasure: Minerals and vitamins, shakes

-The Ehlers-Danlos syndromes are a group of connective tissue disorders that can be inherited and are varied both in how affect the body and in their genetic causes. They are generally characterized by joint hypermobility (joints that stretch further than normal), skin hyperextensibility (skin that can be stretched further than normal), and tissue fragility.The Ehlers-Danlos syndromes (EDS) are currently classified into thirteen subtypes. Each EDS subtype has a set of clinical criteria that help guide diagnosis; a patient’s physical signs and symptoms will be matched up to the major and minor criteria to identify the subtype that is the most complete fit. There is substantial symptom overlap between the EDS subtypes and the other connective tissue disorders including hypermobility spectrum disorders, as well as a lot of variability, so a definitive diagnosis for all the EDS subtypes when the gene mutation is known—all but hypermobile EDS (hEDS)—also calls for confirmation by testing to identify the responsible variant for the gene affected in each subtype.

*genetic testing

* JointsJoint hypermobility; loose/unstable joints which are prone to frequent dislocations and/or subluxations; joint pain; hyperextensible joints (they move beyond the joint’s normal range); early onset of osteoarthritis.SkinSoft velvety-like skin; variable skin hyper-extensibility; fragile skin that tears or bruises easily (bruising may be severe); severe scarring; slow and poor wound healing; development of molluscoid pseudo tumors (fleshy lesions associated with scars over pressure areas).Miscellaneous/Less CommonChronic, early onset, debilitating musculoskeletal pain (usually associated with the Hypermobility Type); arterial/intestinal/uterine fragility or rupture (usually associated with the Vascular Type); scoliosis at birth and scleral fragility (associated with the Kyphoscoliosis Type); poor muscle tone (associated with the Arthrochalasia Type); mitral valve prolapse; and gum disease.Each type of Ehlers-Danlos syndrome is defined as a distinct problem in connective tissue. Connective tissue is what the body uses to provide strength and elasticity; normal connective tissue holds strong proteins that allow tissue to be stretched but not beyond its limit, and then safely return that tissue to normal. Connective tissue is found throughout the body, and Ehlers-Danlos syndromes are structural problems. An analogy: If one builds a house with faulty materials, say half the necessary wood or with soft aluminum nails, it is certain there will be problems. Some problems are more likely to show up than others, but because those materials were used everywhere and are not necessarily visible, one can be surprised by where a problem shows up or how serious it is.It is much the same thing with an Ehlers-Danlos Syndrome and connective tissue.The connective tissue a person with EDS is built with is not structured the way it should be. With a badly-constructed or processed connective tissue, some or all of the tissue in the EDS-affected body can be pulled beyond normal limits which causes damage. Connective tissue can be found almost anywhere, in skin, muscles, tendons and ligaments, blood vessels, organs, gums, eyes, and so on.The problems resulting from one’s body being built out of a protein that behaves unreliably can be widespread and in a wide range of severity. It shows up in places that seem unrelated until the underlying connection to an Ehlers-Danlos syndrome is recognized.

-Biophysical profile

Learn about and keep track of your baby's health. Special ultrasoundmethods are used to keep track of movement, increases in heart rate with movement (nonstress test), muscle tone, breathing rate, and the amount of amniotic fluid (amniotic fluid index) surrounding your baby. If these five areas are within a normal range, your baby is considered to be in good health.Check on your baby's health if you have:Hyperthyroidism.Bleeding problems.Lupus.Chronic kidney disease.Type 1 diabetes or gestational diabetes.High blood pressure (hypertension).Preeclampsia.A small amount of amniotic fluid (oligohydramnios) or too much amniotic fluid (polyhydramnios).A multiple pregnancy (such as twins or triplets).A pregnancy that has gone past your due date, between 40 and 42 weeks.

- The term broncholithiasis is used to denote the presence of calcified or ossified material within the lumen of the bronchus (1). A broncholith is usually formed by erosion by and extrusion of a calcified adjacent lymph node into the bronchial lumen and is usually associated with long-standing foci of necrotizing granulomatous lymphadenitis (Fig 1). Other causes of broncholithiasis include (a)aspiration of bone tissue or in situ calcification of aspirated foreign material; (b) erosion by and extrusion of calcified or ossified bronchial cartilage plates; and (c) migration to a bronchus of calcified material from a distant site, such as a pleural plaque or the kidney (via a nephrobronchial fistula) (1). Some authors expanded the definition to include those cases in which peribronchial calcified lymph nodes distort the bronchial tree without extrusion of the lymph node into the bronchus (2,3).

*dry unproductive cough, poor PO intake, No N/V/D, fever (104) with fatigue, poor sleep from, cough, congestion, mouth breathing, stinky odor, BMxfew times a day, green nasal discharge, wheezing (Albuterol was given). 

*Dx with flu if child has already had this for about a week

*Flu that is over 48 hours, cant iven tamiflu

*Augmentin 

*This pt has hx of febrile seizures, mom was giving motrin and tylenol alternatively to break fever but the fever wont go away

*give abx for 24 hours before kid can go back to school. 

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Pediatric/outpt/Dr.Baez

-Recommend on FacebookTweetMolluscum contagiosum is an infection caused by a poxvirus (molluscum contagiosum virus). The result of the infection is usually a benign, mild skin disease characterized by lesions (growths) that may appear anywhere on the body. Within 6-12 months, Molluscum contagiosum typically resolves without scarring but may take as long as 4 years.The lesions, known as Mollusca, are small, raised, and usually white, pink, or flesh-colored with a dimple or pit in the center. They often have a pearly appearance. They’re usually smooth and firm. In most people, the lesions range from about the size of a pinhead to as large as a pencil eraser (2 to 5 millimeters in diameter). They may become itchy, sore, red, and/or swollen.Mollusca may occur anywhere on the body including the face, neck, arms, legs, abdomen, and genital area, alone or in groups. The lesions are rarely found on the palms of the hands or the soles of the feet.

-The virus that causes molluscum spreads from direct person-to-person physical contact and through contaminated fomites. Fomites are inanimate objects that can become contaminated with virus; in the instance of molluscum contagiosum this can include linens such as clothing and towels, bathing sponges, pool equipment, and toys. Although the virus might be spread by sharing swimming pools, baths, saunas, or other wet and warm environments, this has not been proven. Researchers who have investigated this idea think it is more likely the virus is spread by sharing towels and other items around a pool or sauna than through water.Someone with molluscum can spread it to other parts of their body by touching or scratching a lesion and then touching their body somewhere else. This is called autoinoculation. Shaving and electrolysis can also spread mollusca to other parts of the body.

cryotherapy & topical therapy