Infantile Spasms and TSC: A Devastating Diagnosis

http://drpeds.blogspot.com/http://funnytrivias.blogspot.com/Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and KEM HOSPITAL MUMBAI INDIA

Respiratory distress severity score RDSS

Respiratory distress severity score RDSS

total score 0-4 = mild; 5-7= moderate; >8 severe

score	Respiratory Rate	RR	wheezing	aeration	retractions
	0-1yr	1-2yr
0	20-40	15-30	none	all fields	none
1	41-55	31-45	Mild exp	4 or more fields	mild
2	>55	>45	insp and exp	<4 fields	marked

Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and
KEM HOSPITAL MUMBAI INDIA

Respiratory distress severity score RDSS

FLUID DISTRIBUTION per kg body weight

Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and
KEM HOSPITAL MUMBAI INDIA



Neonate Child Adult

Total water 750 ml/kg 650 ml/kg 550 ml/kg

Intracellular 350 ml/kg 350 ml/kg 300 ml/kg
water

Extracellular 400 ml/kg 300 ml/kg 250 ml/kg
water

Whole blood 90 ml/kg 80 ml/kg 75 ml/kg

Plasma 40 ml/kg 35 ml/kg 35 ml/kg

MAINTENANCE Fluid REQUIREMENTS in children

MAINTENANCE Fluid REQUIREMENTS in children
IV fluid: 4.3% dextrose in 0.18% saline.
Add to each litre: 1g (13 mEq) of potassium chloride (and 1 ampoule - 2 ml - of Intravite if IV
maintenance and nil by mouth is to be continued for more than 3 days).
Amount:
0-10 kg: 100 ml/kg/day
4 ml/kg/hr

11-20 kg: 1000 ml + 50 ml/kg/day for each kg above 10 kg
40 ml + 2 ml/kg/hr

Above 20 kg: 1500 ml + 20 ml/kg/day for each kg above 20 kg
60 ml + 1 ml/kg/hr

all fits as per Holiday and Segar's formula



Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and KEM HOSPITAL MUMBAI INDIA

Weech's formula weight height estimates

weight	in Kg	in Pounds
at birth	3.25	7
3-12 mo	[age(month)plus9] by 2	age (mo) plus 11
1-6 yr	[age(yr)2]+8	[age(yr)5]+17
7-12 yr	[7x-5]/2	7x-5
height	cm	inches
at birth	50	20
1 yr	75	30
2-12 yr	6x+77	2x+30

Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and
KEM HOSPITAL MUMBAI INDIA

Tanner staging sexual maturity score

Pubic hair (both male and female)

1. Tanner I -- no pubic hair at all [10 and under] (prepubertal state)
2. Tanner II -- small amount of long, downy hair with slight pigmentation at the base of the penis and scrotum (males) or on the labia majora [10-11](female)
3. Tanner III -- hair becomes more coarse and curly, and begins to extend laterally [12-14]
4. Tanner IV -- adult-like hair quality, extending across pubis but sparing medial thighs [13-15]
5. Tanner V -- hair extends to medial surface of the thighs [16+]

Genitals (male)

1. Tanner I -- prepubertal (testicular volume less than 1.5 ml; small penis of 3 cm or less)
2. Tanner II -- testicular volume between 1.6 and 6 ml; skin on scrotum thins, reddens and enlarges; penis length unchanged
3. Tanner III -- testicular volume between 6 and 12 ml; scrotum enlarges further; penis begins to lengthen to about 6 cm
4. Tanner IV -- testicular volume between 12 and 20 ml; scrotum enlarges further and darkens; penis increases in length to 10cm and circumference
5. Tanner V -- testicular volume greater than 20 ml; adult scrotum and penis of 15 cm in length

Breasts (female)

1. Tanner I -- no glandular tissue; areola follows the skin contours of the chest (prepubertal)
2. Tanner II -- breast bud forms, with small area of surrounding glandular tissue; areola begins to widen
3. Tanner III -- breast begins to become more elevated, and extends beyond the borders of the areola, which continues to widen but remains in contour with surrounding breast
4. Tanner IV -- increased breast size and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast
5. Tanner V -- breast reaches final adult size; areola returns to contour of the surrounding breast, with a projecting central papilla.

clinical manifestations of childhood tuberculosis