2nd year

• Common blood diseases in pediatrics

  • Anemia
  • Sickle Cell Disease
  • Thalassemia
  • Hemophilia
  • Immune Thrombocytopenic Purpura (ITP)
  • Leukemia
  • Von Willebrand Disease
  • Hereditary Spherocytosis
• Anemia


  A condition characterized by a deficiency of red blood cells or hemoglobin, leading to fatigue and weakness. Causes can include iron deficiency, genetic disorders, or chronic diseases.
• Sickle Cell Disease


  • A genetic disorder where red blood cells are abnormally shaped, causing blockages in blood flow and leading to pain and organ damage.
• Thalassemia


  • A group of inherited blood disorders affecting hemoglobin production, leading to anemia and requiring regular blood transfusions.
• Hemophilia


  • A genetic disorder where blood doesn't clot properly due to a deficiency of clotting factors, leading to excessive bleeding from minor injuries.
• Immune Thrombocytopenic Purpura (ITP)


  • An autoimmune disorder where the immune system destroys platelets, leading to easy bruising and bleeding.
• Leukemia


  • A type of cancer affecting the blood and bone marrow, characterized by the overproduction of abnormal white blood cells.
• Von Willebrand Disease


  • A bleeding disorder caused by a deficiency or dysfunction of von Willebrand factor, affecting platelet function and clot formation.
• Hereditary Spherocytosis


  • A genetic condition causing red blood cells to be sphere-shaped and fragile, leading to hemolytic anemia.
• These conditions require specific diagnosis and management tailored to each child's needs.
• Erik Erikson's theory of psychosocial development


  Outlines eight stages that an individual passes through over their lifetime
• Erikson's stages of psychosocial development

  1. Infancy (0-1 year): Trust vs. Mistrust

  2. Early Childhood (1-3 years): Autonomy vs. Shame and Doubt

  3. Preschool (3-6 years): Initiative vs. Guilt

  4. School Age (6-12 years): Industry vs. Inferiority

  5. Adolescence (12-18 years): Identity vs. Role Confusion

  6. Young Adulthood (18-40 years): Intimacy vs. Isolation

  7. Middle Adulthood (40-65 years): Generativity vs. Stagnation

  8. Maturity (65+ years): Ego Integrity vs. Despair
• Erikson's stages

  • Each stage is characterized by a central conflict that serves as a turning point in development
  • Each stage involves specific developmental tasks and challenges that contribute to an individual's overall psychological growth
• Drugs affecting the endocrine system

  • Pituitary Agents
  • Hypothalamic Agents
  • Adrenocortical Agents
  • Thyroid & Antithyroid Agents
  • Insulin & Antidiabetic Agents
• Endocrine system


  Organs of the body that secrete hormones directly into body fluids such as blood
• Hormones


  Chemical messengers secreted by endocrine glands or tissues into blood, travel everywhere blood goes, and affect only target cells with receptors
• Hormones of the anterior pituitary

  • Growth hormone
  • Thyroid-stimulating hormone
  • Adrenocorticotropic hormone
  • Follicle-stimulating hormone
  • Luteinizing hormone
  • Prolactin
• Hormones of the posterior pituitary

  • Antidiuretic hormone (vasopressin)
  • Oxytocin
• Growth hormone agonists


  Responsible for linear skeletal growth, growth of internal organs, protein synthesis, and stimulation of processes required for normal growth
• Hypopituitarism


  Growth hormone deficiency often seen before any other signs and symptoms, caused by developmental abnormalities, congenital defects, circulatory disturbances, inflammation, and pituitary tumors
• Dwarfism


  Growth hormone deficiency in children resulting in short stature
• Somatotropin deficiency syndrome (SDS)


  Condition in adults with hypopituitarism caused by pituitary tumors, trauma, or previous treatment for growth hormone deficiency as children
• Growth hormone agonists


  • Replace human growth hormone and stimulate skeletal growth, growth of internal organs, and protein synthesis
  • Indicated for long-term treatment of growth failure in various conditions
• Growth hormone antagonists


  Used to treat growth hormone hypersecretion (hyperpituitarism) caused by pituitary tumors
• Gigantism


  Growth hormone hypersecretion before epiphyseal plate closure, causing acceleration in linear skeletal growth
• Acromegaly


  Growth hormone hypersecretion after epiphyseal closure, causing enlargement of peripheral body parts and internal organs
• Growth hormone antagonists

  • Act on postsynaptic dopamine receptors to inhibit growth hormone secretion
  • Octreotide and lanreotide are somatostatin analogues used instead of somatostatin
• Posterior pituitary hormones

  Antidiuretic hormone (vasopressin) and oxytocin, stored in the posterior pituitary
• Antidiuretic hormone (vasopressin)


  Has antidiuretic, hemostatic, and vasopressor properties, affected in diabetes insipidus
• Drugs affecting posterior pituitary hormones

  • Have pressor and antidiuretic effects, increase clotting factor VIII
  • Used to treat neurogenic diabetes insipidus and hemophilia A
• Hypothalamic agents

  Hormones found in minute quantities, not all available for pharmacological use, used mostly for diagnostic testing, treating some cancers, or as fertility adjuncts
• Hypothalamic agonists


  • Analogues of gonadotropin-releasing hormone, decrease sex hormone production
  • Used to treat precocious puberty, endometriosis, and advanced prostate cancer
• Hypothalamic antagonists


  • Decrease testosterone, sperm count, and female sex hormones
  • Used to treat advanced prostate cancer and inhibit premature LH surge in fertility treatment
• Adrenocortical agents

  • Glucocorticoids
  • Mineralocorticoids
  • Androgens
• Glucocorticoids

  Stimulate increase in glucose levels, increase protein breakdown, decrease protein formation, and promote lipogenesis
• Glucocorticoids


  • Bind to cytoplasmic receptors to reduce inflammation and suppress the immune system
  • Some also have mineralocorticoid activity affecting electrolytes and water levels
• Indications for glucocorticoids


  Short-term treatment of inflammatory disorders by blocking arachidonic acid and decreasing prostaglandin and leukotriene formation
• Glucocorticoids


  Agents that stimulate an increase in glucose levels for energy, increase the rate of protein breakdown and decrease the rate of protein formation from amino acids to preserve energy, and are capable of lipogenesis (formation and storage of fat in the body for energy source)
• Therapeutic Action of Glucocorticoids


  Bind to cytoplasmic receptors of target cells to form complex reactions needed to reduce inflammation and to suppress immune system
• Other glucocorticoids

  Hydrocortisone, cortisone, and prednisone also have mineralocorticoid activity so they can affect potassium, sodium, and water levels, limit the activity of lymphocytes to act within the immune system, and inhibit the spread of phagocytes to the bloodstream and injured tissues