1. Childhood Diseases and Disorders
Pathophysiology

2. Infectious Diseases
Viruses
Bacterial
Fungal
Parasitic

3. Viral Diseases

4. Measles, Mumps, and Rubella (MMR)
Measles (Rubeola)
Highly contagious (incubation period is 7-14 days)
Symptoms include fever, inflammation of respiratory mucous membranes, rash, and spots in mouth called Koplik’s spots
Treatment is fluids, fever reducer, and rest
May cause encephalitis or meningitis or ear infections and conjunctivitis (pink eye)
Mumps
Affects parotid glands (one of the three salivary glands)
Spread by saliva with incubation period but may be as long as 25 days
Blood test determines presence and symptoms are chills, swelling of glands, fever
Treatment is to treat symptoms
May cause orchitis (inflammation of testis) or nerve conduction deafness
Rubella (German Measles or three day measles)
Incubation period of days
Symptoms like rubeola but lighter in color; also joint pain and lymph node involvement
Diagnosis through a blood test
May cause fetal problems or birth defects is pregnant women are exposed (80% chance in first 3 mos)

5. MMR

6. Varicella (Chicken Pox)/ Poliomyelitis
Incubation of days; caused by varicella-zoster
May have shingles as an adult
Symptoms include classic dew drop rose petal macular rash (vesicles)
Poliomyelitis
Incubation of 3-6 days for milder form, 7-21 for severe form
Spread through oral fecal routes
Headache, sore throat and then paralysis
Stool sample or throat cultures confirms diagnosis
Treatment is only supportive; physical therapy or respiratory ventilation may be needed

7. Chicken Pox Polio

8. Influenza/ Common Cold
Symptoms are fever, headache, joint pain, runny nose, etc
No treatment except rest, hydration, nasal sprays
Common Cold (rhinovirus)
Symptoms are rhinitis

9. Mononucleosis Caused by Epstein-Barr virus Spread through saliva
Symptoms happen 4-7 days after exposure
Diagnosis through blood test showing rise in WBC
Takes 3-4 weeks to recover and sports should be avoided for one month after to protect the spleen

10. Acquired Immunodeficiency Syndrome (AIDS)
Caused by HIV virus
In 1980’s most children with the disease got it from infected blood because they were hemophiliacs and received transfusions. Today most get it from perinatal transmission
Some sexually active teens have the disease
2.1 million live with HIV
Time between HIV infection and AIDS is shorter in children and infants

11. Bacterial Diseases

12. Diphtheria / Pertussis
Once had a fatality rate of 20% in 1920’s
Caused by Corynebacterium diphtheriae
Produces a membranous coating of pharynx, nose, and sometimes tracheobronchial tree called exudate with proteins and WBC that seep from tissue
Diagnosis is gray membrane covering throat and positive culture
Treatment is antibiotic and diphtheria antitoxin
Pertussis (whooping cough)
Caused by Bordetella pertussis
Incubation is 6-10 days but can be as long as 21 days
Symptoms are
Catarrhal- increase in inflammation of mucous membranes
Paroxysmal-spasm or convulsion with violent coughing, cyanosis, vomiting
Convalescent stage-gradually reduced coughing
Treatment is with antibiotics and supportive therapy but pneumonia can be a problem

13. Tuberculosis (TB) Affects respiratory system Currently on the rise
Caused by Mycobacterium tuberculosis
Also found in GI system and the bones, brain, and lymph nodes
Incubation period is 4-12 weeks
Symptoms include bloody sputum, fever, cough, lymph node enlargement
Disease in children often stays dormant
Diagnosis is by positive skin test, sputum culture and chest x-rays
Treatment is rest, drug therapy
There is a TB vaccine, bacille Calmette-Guesnn (BCG) for places with infection greater than 1% per year

14. Tularemia (Rabbit fever or deer fly fever)
Caused by Francisella tularensis
Symptoms include headaches, lymph node swelling, chills, vomiting
Diagnosis is with blood test or chest x-ray to rule our pneumonia
Treatment is with antibiotics
Prevention is protection from ticks

15. Impetigo / Acute Tonsillitis / Otitis Media
Caused by pyoderma commonly found on face and hands of children
Caused by Staphylococcus aureus
Acute Tonsillitis
Infection of palatine tonsils caused by beta-hemolytic streptococci
Symptoms are sore throat, cough, fever, trouble swallowing
Diagnosis with throat culture
Treatment is tonsillectomy
Otitis Media
Bacterial infection of middle ear
If persistent, myringotomy with tympanopathy tubes might be treatment

16. Fungal Diseases

17. Candidiasis/ Tinea Candidiasis Tinea
Also known as thrush, oral fungal infection
Caused by Candida albicans
White plaques on mucous membranes and tongue
Treatment of choice is usually swabbing mouth with oral nystatin
Tinea
Also known as ringworm
Usually affect scalp and between toes
Males also get it in the groin area

18. Parasitic Diseases

19. Giardiasis / Pediculosis
Infection with protozoa called giardia
Caused by the Giardia lamblia and affects the digestive system
Symptoms include watery diarrhea , nausea, flatulence
Stool will float and be shiny
May take many samples to identify parasite
Treatment is furazolidone or similar drugs; clear fluids to prevent dehydration
Pediculosis
Lice acceptance
Adult females produce 6 eggs/ 24 hours
Nits (eggs) can be seen in hair
Treated with permethrin 1% crème rinse

20. Pinworms/ Roundworms
Pinworms (seatworms or threadworms) are nematodes that infect intestines and rectum
No harmful, just itchy
Caused by Enterobius vermicularis
Eggs can survive for 2-3 weeks; females lay 10,000-20,000 eggs at anus
Symptoms are anal itching and look like white threads
Diagnosis is by microscopic exam of stool
Treatment is OTC or prescription drug therapy; may need to repeat in 2 weeks
Roundworms
Ascaris lumbricoides found in soil
Symptoms are abdominal pain, excessive gas, weight loss, vomiting
Diagnosis is through stool sample
Treatment is same as for pinworms

21. Respiratory Diseases
SIDS
Croup
Adenopid Hyperplasia
Asthma
Pneumonia

22. Respiratory Illness

23. Sudden Infant Death Syndrome (SIDS) / Croup
Unexplainable death of an infant under age one; also known as crib death
Cause unknown but suggested that infants be put in supine rather than prone position
Only diagnosis is autopsy
Croup
Also known as laryngotracheobronchitis (URI)
Caused by parainfluenza 1 and 2 viruses in children from 3 mos- 3 yrs old
Symptoms are inspiratory stridor, difficulty breathing at night
Diagnosis is physical exam
Treatment is usually high humidity, fluids, rest, racemic epinephrine

24. Adenoid Hyperplasia/ Asthma
Enlargement of the pharyngeal tonsils
Symptoms are blockage of Eustachian tubes causing otitis media; difficulty breathing
Diagnosis is exam/ throat culture
Treatment is antibiotic therapy or adenoidectomy
Asthma
More than 5 million children under age 18 diagnosed (I out of every 4)
#1 reason for school absences
Cause unknown
Symptoms are respiratory distress
Diagnosis is by chest x-rays, allergy test, pulmonary function tests, physical exam
Treatment is with medications like a bronchodilator and anti-inflammatory drugs
Monitored with peak flow meter
Prevention is knowing triggers

25. Pneumonia Infection of the lung parenchyma
Can be viral or bacterial; alveolar air spaces become filled with fluid
Symptoms are wheezing, coughing, fever, malaise
Diagnosis is by chest x-ray and auscultation of the chest
Treatment varies (antibiotics if bacterial)

26. Digestive Diseases / Cardiovascular Diseases
Colic- in babies
Fluid Imbalances
Food Allergies
Eating Disorders
Cardiovascular
Most are related to genetic or developmental disorders

27. Fluid Imbalances / Food Allergies/ Eating Disorders
Children have higher exchange of fluids so diarrhea or vomiting can be serious
Dehydration serious
Treatment includes rehydration and electrolyte replacement
Food Allergies
Overreaction of immune system to a particular food
Reaction may take seconds or even hours
More common in children especially under age 1
After age three, if one develops it stays for adult life
Testing can be done
Eating Disorders
Problem during adolescence
Anorexia and bulimia most common

28. Musculoskeletal Diseases / Blood Diseases
Legg-Calve-Perthes (LCP)
Ewing’s Sarcoma
Blood Diseases
Leukemia

29. Musculoskeletal diseases
Legg-Calve-Perthes (LCP)
Avascular necrosis of the upper end of the femur
Blood flow is reduced to the head of the femur
Most common in boys age 4-8
Only symptom is pain when walking
Cause unknown
Diagnosis with x-ray
Treatment is maintain position of femur, rest, ROM exercises, traction, etc.
Ewing’s Sarcoma
More common in males; found in long bones like femur
Diagnosis with x-ray, CT scan, MRI
Treatment is chemotherapy or amputation

30. Neurologic Diseases / Eye and Ear Diseases
Reye’s Syndrome
Eye and Ear
Strabismus
Deafness

31. Neurologic Diseases Reyes Syndrome
Acute encephalopathy seen in children under age 15
Cause unknown but relationship with use of aspirin
Symptoms are nausea and vomiting, liver enlargement, seizures
Diagnosis should be suspected in a child who had a recent viral illness; blood testing of liver enzymes and lumbar puncture (spinal tap)
Treatment is in ICU

32. Eye and Ear Diseases Strabismus Deafness Lazy eye or crossed
Should not be present after age 4 mos
Deafness
Ranges from mild to complete
Cause unknown but may be from trauma, infections, or exposure to ototoxic drugs
Audiometric testing is needed for accurate diagnosis
Treatment depends on extent of deafness
Cochlear implants are now inserted surgically to stimulate 8th cranial nerve

33. Blood Diseases Leukemia
Malignancy of the blood-forming cells located in bone marrow
Most common cancer in children
Cause is unknown
Most common type in children is ALL (Acute Lymphoblastic Leukemia)
Symptoms are pale skin, easy bleeding, bruising, abdominal pain, fever
Diagnosed with blood tests and bone marrow biopsy
Treatment is chemotherapy or radiation in some cases

34. Trauma
Child Abuse
Suicide
Drug Abuse
Poisoning

35. Child Abuse More common than any other pediatric illness
Neglect vs. abuse
Neglect is failing to provide basic needs
Abuse is causing harm
Diagnosed with physical exam and interview of child and care providers
Cigarette and hands most common items of abuse
Shaking Baby Syndrome common
Types of abuse
Sexual
Physical
Emotional
Verbal

36. Suicide 3rd leading cause of death (15-24 years)
Firearms used in 57% of male suicides
Depression, alcohol and drug use are contributing factors
Highest in incarcerated youths, gay or bisexual, and sexually abused
Girls attempt more but males are more successful in suicide attempts

37. Poisoning Among top five causes of death under age 10; 75% under age 6
Household items and medications are common forms of poisoning
Lead poisoning is chronic and blood can be tested to diagnose; caused neurological disorders
Treatment MAY be medication to induce vomiting