Croup Grades: Exertional stridor → only with exercise At rest stridor With retraction subcostal & intercostal With Resp. failure “cyanosis” 1, 2 → outpatient treatment 3, 4 → hospitalization Types: Bacterial: epiglottitis, tracheitis → high grade fever, anorexia, flushing, toxic, bad general condition → organism is Staph. Aureus Viral: laryngitis, lanyrgo-bronchitis → دي حة ب الذ رت ه ظ ة أ ج فرد و ب ح و ش ر ة وي شLaryngo-tracheobronchitis → with wheezy chest No tongue depressor in any case of croup → epiglottitis Stridor is more common at night due to more congestion Treatment Humidify the vocal cords At the reception Warm saline or Epinephrine, racemic: 0.01 mg/kg/dose → (ampule 1mg/1ml) → ي عل لة اح10 وا ل ي ك ل ك ل رطة ش م و ادي سAt home Vapozol ( أو ح ة غ ب ص) → ½ ة ق =ش ن يس ي وA ن خ ر ماء سأ لت ي عل ة لق مع1
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Croup
Grades: Exertional stridor → only with exercise
At rest stridor
With retraction subcostal & intercostal
With Resp. failure “cyanosis”
1, 2 → outpatient treatment
3, 4 → hospitalization
Types: Bacterial: epiglottitis, tracheitis → high grade fever, anorexia, flushing, toxic, bad general
condition → organism is Staph. Aureus
Viral: laryngitis, lanyrgo-bronchitis → دي الذبحة ظهرت فجأة و برد و رشح شوية
Laryngo-tracheobronchitis → with wheezy chest
No tongue depressor in any case of croup → epiglottitis
Stridor is more common at night due to more congestion
+ Oral Ca with it or 1 day before it → الحقنة 15 لمدة بعد يوم
To prevent hypocalcemia
Dosage: Hical 50-70 mg/kg/day
اي ( و ) وبعدها تانية حقنة ادي مكنتشكويسة لو تانية عادية اشعة هعمل اسبوعين بعداسبوعين كمان استني
If good → healing rickets → oral Vitamin D
Therapeutic dose: 3000-5000 unit/day
Prophylactic dose: 400-600 unit/day
Trade name:
Decal 1000 unit/5ml → احسنهم ه
Vidrop: 100unit/drop
10
Pedical: 400 unit/5ml
Dosage:
15cm decal = 3000 unit → 5cm/8h كل 5هدي ساعات 8سم
For 1 month واحد شهر لمدة
To avoid vitamin D toxicity [fever, rash, ↓ alertness, jaundice, flushing]
Prophylactic dosage: from 4th month to 1 ½ years
Decal 2cm/day
Pedical 5cm/day
Vidrop → 4 drops/day
{ المغربية وقت بساعة المغرب قبل و الشروق {يتعرضللشمسوقت
نستون جبنة و زبادي ياكل
بعده اللي نخشفي ما قبل صغيرة قصة
It is said that the famous sophist Protagoras took on a student, Euathlus, on the understanding that the student pay Protagoras for his instruction after he had won his first case (in some versions: if and only if Euathlus wins his first court case). Some accounts claim that Protagoras demanded his money as soon as Euathlus completed his education; others say that Protagoras waited until it was obvious that Euathlus was making no effort to take on clients and still others assert that Euathlus made a genuine attempt but that no clients ever came. In any case, Protagoras decided to sue Euathlus for the amount owed.
Protagoras argued that if he won the case he would be paid his money. If Euathlus won the case, Protagoras would still be paid according to the original contract, because Euathlus would have won his first case.
Euathlus, however, claimed that if he won then by the court's decision he would not have to pay Protagoras. If on the other hand Protagoras won then Euathlus would still not have won a case and therefore not be obliged to pay.
The question is: which of the two men is in the right?
يقول بالعربي ترجمة عايز اللي
مصر في كيو اي اعلي انتوا ده بسياجماعة
بعده الي خشعلي و سيبك
Antipyretic
Paracetamol Safe from 1st day of life
11
Not effective if fever is > 38 c → as it work in peripheral PG
Dose: 10-15 mg/kg/dose for 3-4 times /day
Form/ trade names/dosage
Drops
Cetal, pyral 5mg/drop
نقطة 20سم = 1القطارة =
2 drops/kg/dose → الواحد المرة في كيلوا لكل ةنقطتين
Suppositories
Pyral 125
Cetal 125
Pyral 250
In 125 → تكفي تقسمها كيلوا 12اللبوسة ممكن و الواحدة المرة في
Imipenem: االطفال رعاية في اال يعطي خالصوال برة مشموجود
Anti-staph
Ampicillin + flucloxacillin
21
Gentamycin
Vancomycin dose: 12mg/kg/dose
Heart failure: transient except if congenital heart disease
Tachycardia, tachypnea, tender enlarged liver
Treatment
Frusemide: Lasix 1mg/kg/day
Lasix 20mg/2ml
في السم اليوم 9بحل في كيلو لكل سم واحد ادي و سم
كيلوا لكل شرطة ادي ماحله غير من او
كل اقسمة ساعة 12و
To decrease afterload: Capoten: dose 0.5-5mg/kg/day
علي 2 → بندي mg/kg/day
علي 25قرص ملح 12.5يحل محلول سم
فيه سم كل ميلليجرام 2يبقي
كل 1يبقي اقسمة و اليوم في كيلوا لكل ساعة 12سم
Digitalis:
Loading dose: 0.05mg/kg or (50μg /kg)
Maintenance dose: 0.01mg/kg/day or (10μg/kg/day)
Digitalizing dose: 50μg/kg
علي ½ الكمية ساعات 8هدي
علي ¼ الكمية ادي ساعات 8ثم
علي ¼ اخر ساعات 8ثم
Digitalis is contraindicated in: obstructive lesions as in M.S
Don't tire tired horse
Pulmonary stenosis
Cardiomyopathy
22
H ypertrophic Obstructive Cardiomyopathy (HOCM) → infant of diabetic mother (As ↑ insulin → ↑ deposition of phospholipids in the septum) → هيشيع النوكسين خد لو دي → ده الحالة ايه عالجها → Inderal
Any neonate with cough in the first 4 months is considered pneumonia until proved otherwise
Treated as pneumonia in the outpatient: بسفي الرئوي االلتهاب زي هيتعالجالحارجية العيادة
Antibiotics course for 7-10 days at least
G-ve injection
G +ve
Oral macrolides: azithromycin or erythromycin
Amoxicillin + clavulinic acid
Cough depressant Herbal سنة اول في نهائي حاجة ممنوعة ممكن
Active respiratory infection حاالت في ممنوع
After 1 year Cough sedative for dry cough or pertussis
All doses are: 1-2mg/kg/day except 1 drug
2P 2B 1C DONE
2P P holcodine 0.5-1 mg/kg/day
Cyrinol 4mg/5ml → 0.7mg/1ml → 0.7mg/kg/day → 1ml/kg/day 1 سماليوم في كيلوا لكل
P ipazethate 1-2mg/kg/day
Selgon
Suppositories 10mg → تقضي سنة ( 10اللبوسة قبل ممنوع )كيلوا
Drops 40mg/1ml every 1 ml =20 drops → 40mg/20drops → 2mg/drop → 2mg/kg/day → 1drop/kg/day اليوم في كيلوا لكل نقطة
23
2B B utamirate 1-2mg/kg/day
Sinecod فيهم واحد اقوي ده
Syrup 7.5mg/5ml → 1.5mg/1ml → 1.5mg/kg/day → 1ml/kg/day 1 سماليوم في كيلوا لكل
Drops: 0.5mg/drop → 4 كيلوا لكل نقطتين او كيلوا لكل نقط
Other trade name: Cough cut syrup: 1 اليوم في كيلوا لكل سم
B enproperine 1-2mg/kg/day
Pectipro syrup 10mg/5ml → 2mg/1ml → 2mg/kg/day → 1 كيلو لكل سماليوم في