early childhood path Flashcards
major cause of death in 1mo t0 12mo
SIDS - 1/2 of death
def. sudden unexpected death
instant death occurring within 24hrs of onset of Sx under 12months
def. SIDS
sudden unexpected death with death occuring in sleep and cause remains unknown even after investigations including autopsy and clinical Hx
what is cause of SIDS
unknown - diagnosis of exclusion
peak of SIDS
1-4 mos
major SIDS intervention
sleep in back
risk factors for SIDS
- prone or side sleep
- soft bedding
- maternal smoking
- overheating
- late or no prenatal care
- young mom
- premature
8 . male
3 genetic factors
- cardiac ion channel defects
- neurotransmitter assoc. defects
- complement C4 defects
5 common path findings in SIDS
- thoracic petechiae
- pulm congestion and edema
- mild resp inflammation
- mild brain swelling
- empty bladder
what is ontario system for investigation
MD coroner system
3 parts to pre-autopsy
- scene investigation
- circ. of death
- infant and fam. medical Hx
steps to autopsy (7)
- external exam
- photograph
- diagnostic imaging
- complete internal exam
- detailed neuro exam
- microscopic exam
- microbio/chemical tests
6 other causes of SUID
- infection
- CNS disorder
- asthma
- CV
- metabolic
- GI
def. cholestasis
reduction in bile formation or bile flow resulting in accumulation of bile - bilirubin - jaundice
features of infant jaundice
- yellow discoloration in sclera, skin, internal
- pale stool
- dark urine
what level is needed to cause jaundice
2-3 in adults, over 5 in infants
what is physiologic jaundice
unconjugated bulirubinemia in infacnts - up to 15%
def. kernicterus
deposition of bilirubin in basal ganglia - neuro impariment
*** top 3 causes of early infant cholestais
- biliary atresia
- idiopathic neonatal hepatitis
- A1-antitrypsiin def.
3 steps to investigate
- biochem - unconjugated?
- diagnotic imaging
- liver biopsy
def. biliary atresia
pregressive necrotizing infalmmatory process affecting the extrahepatic biliary system
- loss of bile duct patency
2 main forms of atresia
- perinatal form (80%) - forms later
2. fetal form (20%) - from birth
causes of two forms
perinatal - progressive destruction of bilairy system
fetal - abnormal dev. of biliary system
3 patho types of biliary atresia
type 1 and 2 - limited to ductal system below porta hepatis type 3 (90%) - involves porta hepatis and ducts
what happens to liver in atresia
damage due to bile backup
3 types of imaging for atresia
- ultrasound
- HIDA scan
3 operative cholangiogram
what is needed for atresia diagnosis
liver biopsy
3 treatments of atresia
- resection and reconstruction of part involved
- kasai procedure
- liver transplant
what is kasai
loops of bowel anastamosed to porta hepatis
- high failure rate after 1 year
