العملي

Question 1

D/D of bradycardia

Answer 1

1. Increased intracranial pressure.
2. Hypothyroidism .
3. Heart block .
4. Drugs : digitalis

Question 2

Low volume pulse

Answer 2

Dehydration .

• Shock .
• heart failure

Question 3

D/D of collapsing pulse :

Answer 3

1) Aortic regurgitation .

2) PDA & peripheral arterio-venous fistula .

Question 4

D/D of pulsus paradoxicus :

Answer 4

1) Severe attack of bronchial asthma .
2) Cardiac tamponed .
3) Constrictive pericarditis .

Question 5

Types of fever 🤒 🥵

Answer 5

Continues fever : Slight diurnal variation ( not > 1 C O ) e.g. : rickettsia & typhoid fever . Intermittent fever : fever for hours and then fall to normal . e.g. : malaria & Hodgkin lymphoma . Remittent fever : fluctuating ( > 1 C O ) but not reach normal temperature . e.g. : TB & abscess ( hectic ). Relapsing fever : temperature returns to normal for days before rising again .

Question 6

Normal heart ra7

Answer 6

o Newborn →100- 180 b/min . 
o <1 year → 80 -160 b/min . 
o 1-2 years → 80 -130 b/min . 
o 2-4 years → 80 – 120 b/min . 
o > 6 years → 70 – 100 b/min .

Question 7

Periodic breathing :

Answer 7

irregular rhythm with apneic spells ( < 15 seconds ).

It is normal in the newborn .

Question 8

Tachypnea : is considered if RR :

Answer 8

Birth – 2 months → > 60 cycle/min. 2 months – 1 year → > 50 cycle/min.

 1- 5 years → > 40 cycle /min.

Question 9

Normal Weight

Answer 9

The average weight at birth → 2.5 – 4kg . at 4 th month → double of birth weight at 1 year → triple the birth weight at 2 years → quadruple the birth weight . after that weight = age ( by years) X 2 + 8

Question 10

Normal hight

Answer 10

the average length at birth = ~ 50 cm . During first year :

 1 st 3 months → +3 cm / month
 Next 3 months → +2cm / month
 From 6-12 months → +1cm / month .

After age of 1 year = age ( by years ) X 5 + 80

Question 11

D/D of enlarged head :

Answer 11

1. Familial .
2. Rickets.
3. Hydrocephaly .
4. Achondroplasia.
5. Chronic hemolytic anemia e.g. sickle cell anemia .
6. Subdural effusion.
7. Space occupying lesion
8. Mucopolysaccharidosis

Question 12

D/D of bulged fontanel :

Answer 12

1. crying .
2. pseudo tumor cerebri .
   3- ⬆️ICP
    Hydrocephaly  IC infection  Neoplasms .  Subdural effusion

Question 13

Fontanel closer

Answer 13

Ant. Fontanel close between ( 9-18 months )
 Post. Fontanel : close at birth up to 2 months of age .

 3rd fontanel may be present in Down syndrome & preterm infant.

 Molding
(  overlapping of skull sutures ) , most often seen with prolonged vaginal delivery . normal shape regained within 1 week

Question 14

Clubbing causes

Answer 14

Pulmonary

Bronchiectasis Empyema. Lung abscess . Cystic fibrosis

Cardiac

GIT

Others

Infective Endocarditis CHD

Hepatic Cirrhosis Coeliac disease IBD

Idiopathic Graves’ disease

Familial

Question 15

Skin of neonate normal here but abnormal in older

Answer 15

1- Vasomotor instability with cutis marmorata, telangiectasia, phlebectasia (intermittent mottling with venous prominence), and acrocyanosis (feet and hands) is normal in a premature infant.
2-Mongolian spots are transient, dark blue to black pigmented macules seen over the lower back and buttocks (دفرة علي😂)
3-milia