NCM 1-FINALS

• Tonsillitis


  Inflammation of the tonsils
• Signs and symptoms of tonsillitis

  • Swollen tonsils
  • Sore throat
  • Difficulty swallowing
  • Tender lymph nodes on the sides of the neck

  
• Most cases of tonsillitis are caused by infection with a common virus, but bacterial infections also may cause tonsillitis
• Common signs and symptoms of tonsillitis

  • Red, swollen tonsils
  • White or yellow coating or patches on the tonsils
  • Sore throat
  • Difficult or painful swallowing
  • Fever
  • Enlarged, tender glands (lymph nodes) in the neck
  • A scratchy, muffled or throaty voice
  • Bad breath
  • Stomachache
  • Neck pain or stiff neck
  • Headache
• Signs of tonsillitis in young children who are unable to describe how they feel

  • Drooling due to difficult or painful swallowing
  • Refusal to eat
  • Unusual fussiness
• Treatment for tonsillitis

  • Antibiotics
  • Removal of the tonsils-frequently occurring TONSILECTOMY
• Prevention of tonsillitis

  • Wash hands thoroughly and frequently, especially after using the toilet and before eating
  • Avoid sharing food, drinking glasses, water bottles or utensils
  • Replace toothbrush after being diagnosed with tonsillitis
• Laryngitis


  A condition that causes inflammation in the larynx, or voice box
• Tonsillitis most commonly affects children between preschool ages and the mid teen age years- often in contact with peers.
• Causes of laryngitis

  • Straining vocal cords by yelling or overusing voice
  • Allergies
  • Stomach acid from acid reflux
  • Viral infections
  • Bacterial infections

  
• Self-management treatment for laryngitis

  • Increase fluid intake
  • Rest to manage the symptoms
  • Limit use of the larynx - avoid talking, singing, or using the voice box
  • Avoid decongestants
  • Breathe moist air
  • Use acetaminophens or ibuprofen to control pain
  • Avoid inhalation of irritants like smoking or second-hand smoke
  • Lifestyle changes
• Medication treatment for laryngitis

  • Antibiotics for bacterial infection
  • Corticosteroids to reduce vocal cord inflammation
  • Surgery (laryngectomy) in cases where the vocal chords have been badly damaged
• Prevention of laryngitis involves measures to limit dryness and irritation to the vocal cords

  
• Adenoiditis


  Recurring infection in the throat, neck and head
• Causes of adenoiditis

  • Bacteria: Group A beta streptococci, Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis, Staphylococcus aureus
  • Viruses: Epstein-Barr virus, Adenovirus, rhinovirus
• Signs and symptoms of adenoiditis

  • Nasal obstruction or difficult breathing
  • Foul smelling breath
  • Voice impairment
  • Fever
  • Sore throat
  • Malaise
  • Earache
  • Snoring
• Diagnosis of adenoiditis

  • Physical examination
  • Blood Culture
  • Throat swab culture
  • X ray of head and neck

  
• Treatment of adenoiditis

  • Adenoids may shrink on their own without any treatment
  • With symptoms like difficulty of breathing and recurrent infections: NASAL DECONGESTANTS, ANTIBIOTICS
  • Severe cases: surgery of ADENOIDECTOMY is indicated
• Nephrotic syndrome


  A condition that causes the kidneys to leak large amounts of protein into the urine, leading to swelling and increased risk of infections
• Symptoms of nephrotic syndrome

  • Swelling
  • Infections
  • Urine changes - frothy
  • Blood clots - important proteins that help prevent blood clotting can be passed out in the urine
• Causes of nephrotic syndrome

  • Glomerulosclerosis - when the inside of the kidney becomes scarred
  • Glomerulonephritis - inflammation inside the kidney
  • Infection - such as HIV or hepatitis
  • Lupus/SLE
  • Diabetes
  • Sickle cell anaemia
  • Certain types of cancer - such as leukemia, multiple myeloma or lymphoma
• Diagnosis of nephrotic syndrome

  • Dipping a dipstick into a urine sample - large amount of protein in the urine
  • Blood test - low level of protein (albumin)
  • Kidney biopsy
• Management of nephrotic syndrome

  • Steroids - Prednisolone to stop protein leaking from the child's kidneys into the urine
  • Diuretics to help reduce fluid build-up
  • Penicillin prescribed during relapses to reduce infection chances
  • Dietary changes to reduce salt intake
  • Vaccinations - pneumococcal and varicella (chickenpox)
  • Additional medications - Levamisole, Cyclophosphamide, Ciclosporin, Tacrolimus, Mycophenolate, Rituximab
  • Albumin infusions to replenish protein lost
• Home treatment for nephrotic syndrome

  • Monitor condition through dipstick urine tests
  • Negative - 0mg of proteinuria per decilitre of urine (mg/dL)
  • Trace - 15 to 30mg/dL
  • 1+ - 30 to 100mg/dL
  • 2+ - 100 to 300mg/dL
  • 3+ - 300 to 1,000mg/dL
  • 4+ - over 1,000mg/dL
  • Dipstick shows 3+ or more of protein in the urine for 3 days in a row, means the child is having a relapse
• Congenital nephrotic syndrome


  Usually caused by an inherited faulty gene, where both parents must have a healthy copy and a faulty one
• Treatment for congenital nephrotic syndrome


  • Frequent albumin infusions to help them grow and develop normally
• Acute glomerulonephritis


  Inflammation and subsequent damage of the glomeruli leading to hematuria, proteinuria, and azotemia
• Symptoms of glomerulonephritis


  • Pink or cola-colored urine from red blood cells in the urine (hematuria)
  • Foamy or bubbly urine due to excess protein in the urine (proteinuria)
  • High blood pressure (hypertension)
  • Fluid retention (edema) with swelling evident in the face, hands, feet and abdomen
  • Urinating less than usual
  • Nausea and vomiting
  • Muscle cramps
  • Fatigue
• Causes of glomerulonephritis


  • Infections - Post-streptococcal glomerulonephritis, Bacterial endocarditis, Viral kidney infections (hepatitis B,C, HIV)
  • Autoimmune diseases - Lupus (SLE), Goodpasture's syndrome
  • Sclerotic conditions - High blood pressure, Diabetic Kidney Disease, Focal segmental glumerulosclerosis
• Possible complications of glomerulonephritis

  • Acute kidney failure
  • Chronic kidney disease
  • High blood pressure
  • Nephrotic syndrome
• Diagnosis of glomerulonephritis

  • Urine test to reveal signs of poor kidney function
  • Blood tests to reveal higher than expected levels of waste products
  • Imaging tests to show irregularity in kidney shape or size
  • Kidney biopsy to confirm diagnosis and assess tissue damage
• Treatment of glomerulonephritis

  • Goal is to protect kidneys from further damage and preserve kidney function
  • Dialysis using an artificial, external kidney that filters the blood
  • End-stage kidney disease requiring regular kidney dialysis or a kidney transplant
• Muscular dystrophy


  A group of more than 30 genetic diseases that cause progressive weakness and degeneration of skeletal muscles used during voluntary movement
• Signs and symptoms of muscular dystrophy

  • Muscle atrophy
  • Difficulty walking, climbing stairs or running
  • Irregular walking gait (like waddling or toe walking)
  • Stiff or loose joints
  • Permanent tightening of the muscles, tendons and skin (contractures)
  • Spasticity
  • Muscle pain
  • Fatigue
  • Trouble swallowing (dysphagia)
  • Heart problems, such as arrhythmia and heart failure (cardiomyopathy)
  • Curved spine (scoliosis)
  • Breathing issues
  • Intellectual disabilities
  • Learning disorder
• Ways to develop muscular dystrophy

  • Recessive inheritance - inherit genetic mutation from both biological parents
  • Dominant inheritance - inherit mutated gene from one biological parent
  • Sex-linked (X-linked) inheritance - females are carriers, males have the condition
• Diagnostic tests for muscular dystrophy

  • Creatine kinase blood test - elevated levels may indicate muscular dystrophy
  • Genetic tests to identify gene mutations
  • Muscle biopsy
  • Electromyography (EMG) to measure electrical activity of muscles and nerves
• Treatment and management of muscular dystrophy

  • Physical and occupational therapies to strengthen and stretch muscles
  • Corticosteroids like prednisolone and deflazacort to delay muscle weakness and improve lung function
  • Mobility aids like canes, braces, walkers and wheelchairs
  • Surgery to relieve tension on contracted muscles and correct spine curvature
  • Heart care with ACE inhibitors, beta-blockers and pacemakers to treat cardiomyopathy
• Genetically female person


  Has two X chromosomes
• Genetically male person


  Has one X and one Y chromosome
• Diagnostic tests for muscular dystrophy

  • Creatine kinase blood test
  • Genetic tests
  • Muscle biopsy
  • Electromyography (EMG)