You're Kidding, Right? – Details, episodes & analysis

Oligoarticular JIA is the most common subtype of juvenile arthritis. Children with oligo have 4 or fewer joints involved in the first 6 months of disease. The biggest complication that requires monitoring for is chronic uveitis which is asymptomatic but ultimately vision threatening if not controlled. 

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(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

Summary:

Exomphalos, or omphalocoele, is a congenital condition where a baby's abdominal organs develop outside the body through the umbilical cord, affecting about 1 in 5000 births, with higher rates in multiple pregnancies (e.g. twins, triplets). It forms between the 6th-10th week of gestation and can be classified as minor or major based on the size of the defect. The condition is sometimes associated with genetic syndromes and other anomalies, necessitating thorough prenatal screening and multidisciplinary care. Tune in to hear more about this condition and an overview of how it is managed.

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(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

MCAD deficiency is a fatty acid oxidation disorder. It is a hereditary disease that is caused by a missing enzyme needed to convert fat into energy. Children with MCAD deficiency therefore cannot fast for very long without developing hypoglycaemia, which can cause brain damage or even death. This is because they cannot use fat and hence ketones as an alternative energy source as the glucose available to them runs low.

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(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

Idiopathic intracranial hypertension (IIH, occasionally called pseudotumour cerebri or benign intracranial hypertension) is a condition characterised by features of raised intracranial pressure without any other cause identified. The main complication is progressive vision loss. 

In this episode we discuss presentation, diagnosis and treatment.

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(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

We use midazolam a lot for procedural sedation in kids. It is a benzodiazepine medication. It has sedative, anxiolytic and amnesic effects - i.e. if it works well, it usually makes the patient a bit sleepy, less anxious, and they often don't remember the procedure. It does NOT have analgesic effects, so you will often use some kind of analgesia for painful procedures. 

Tune in to learn more about this commonly used medication - how we use it, when we use it and what we like and don't like about it!

Constipation is a very common presentation in children - 1 in 3 children will have constipation at some point. Most kids pass a soft bowel action at least once every 2-3 days. 

Most cases of constipation are functional constipation, but there are a number of important differentials to consider. Treatment takes at least as long as the child has been constipated and requires a multi step approach to get on top of! 

You don't want to miss:

• A case based discussion
• Important causes of constipation
• Pathophysiology
• How to describe constipation to parents 
• Important history and examination items 
• Treatment
• Complications

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(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

Inguinal hernias are an important differential for hydrocoeles in baby boys - but don't be fooled, they do less commonly occur in girls too. They are caused by a persistent processus vaginalis, which usually closes in the 28th week of gestation once the testes have gone through in boys. Every patient with an inguinal hernia requires review by a paediatric surgeon as management is operative - either to correct a strangulated hernia if it's picked up late, or to prevent a strangulated hernia. 

You don't want to miss:

• How to explain this condition to a family
• Pathophysiology of inguinal hernias
• Important examination findings
• Management 
• Complications

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(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

Acute lymphoblastic leukaemia is the most common childhood cancer. It is a blood cancer in which the cells that normally develop into lymphocytes mutate and become cancerous and rapidly replace normal cells in the  bone marrow.

• People may have symptoms, such as fever, weakness, and paleness, because they have too few normal blood cells.
• Full blood count and film and a bone marrow evaluation are done for diagnosis.
• Chemotherapy is given and is often effective.

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(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)v

The glasgow coma scale is used all the time to assess the level of consciousness of a patient (especially for those with acute head injury). We give a patient a score out of 15 depending on their motor response, their verbal response and the eye response. There are 6 possible points for motor, 5 for voice and 4 for eyes. The higher the score, the better the level of consciousness in the patient. There is a version we can use for pre verbal kids under 2.

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(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

Pertussis, also known as whooping cough and the 100 day cough, is caused by a bacterial infection. The usual pathogen is Bordetella pertussis, but can also be Bordetella parapertussis. Vaccinations worldwide have overall decreased mortality – prior to vaccination, pertussis was the leading cause of death from communicable disease among US children <14 years old.

Classically, children with pertussis present with coryzal symptoms for about a week, known as the catarrhal phase, followed by a dry, intermittent cough that develops into coughing fits that are the hallmark of the disease. Not every child develops the characteristic "whoop" noise with coughing fits, and therefore it is important to remember pertussis as a differential.

One of the major parts of management is deciding who needs antibiotics, and which close contacts need prophylactic antibiotics.  

You don't want to miss:

• A case
• Explaining the condition to families
• Statistics
• Aetiology
• Presentation
• Complications
• Investigations
• Management

Links and resources:

• Follow us on Instagram @yourekiddingrightdoctors
• Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/

Our email is yourekiddingrightpod@gmail.com

Make sure you hit SUBSCRIBE/FOLLOW so you don't miss out on any pearls of wisdom and RATE if you can to help other people find us!

(This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)