Pediatric Gynecology

Ambiguous genitalia look for adrenogenital syndrome and congenital adrenal hyperplasia, which usually are due to 21-hydroxylase deficiency 90 of cases . Patients are female males with this disease show precocious sexual development. Patients with 21-hydroxylase deficiency have salt-wasting low sodium levels , hyperkalemia, hypotension, and elevated 17-hy-droxyprogesterone. Treat with steroids and IV fluids immediately to prevent death. No patient with ambiguous genitalia should be assigned, a...

Treat chronic pancreatitis with alcohol abstinence oral pancreatic enzyme replacement and fatsoluble vitamin supplements

Mallory-Weiss tears are superficial esophageal erosions that may cause a GI bleed. They usually are seen with vomiting and retching alcoholics and bulimies . Diagnosis and treatment are done endoscopically sclerose any bleeding vessels . Boerhavc's tears are full-thickness esophageal ruptures if not iatrogenic from endoscopy , they are usually due to vomiting or retching alcoholics and bulimics . Diagnose with endoscopy or barium enema, and treat with immediate surgical repair and drainage....

Immunology

Types of hypersensitivity reactions 1. Type I anaphylactic due to preformed IgE antibodies, which cause release of vasoactive amines e.g., histamine, leukotrienes from mast cells and basophils. Examples are anaphylaxis bee stings, food allergy especially peanuts and shellfish , medications especially penicillin and sulfa drugs , rubber glove allergy , atopy, hay fever, urticaria, allergic rhinitis, and some forms of asthma. With chronic type I hypersensitivity atopy, some asthma, allergic...

Metabolic derangements that accompany liver failure

Coagulopathy prolonged prothrombin time in severe cases, partial thromboplastin time may be prolonged. Because the damaged liver cannot use vitamin K, patients must be treated with fresh frozen plasma. 2. Jaundice hyperbilirubinemia elevated conjugated and unconjugated bilirubin with hepatic damage vs. biliary tract disease . 3. Hypoalhuminemia liver synthesizes albumin. 4. Ascites due to portal hypertension and or hypoalhuminemia. Ascites can be detected on physical exam by shifting...