Hepatitis B is caused by a virus that is most often acquired during childbirth.Fulminant hepatitis and death may occur. Chronic infection can occur at much higher rates in kids - in fact 90% of infants exposed will develop hep b if no post exposure prophylaxis is given. Chronic hep B can lead to cirrhosis and/or hepatocellular carcinoma. A major take home point about today's episode is understanding serologic testing! Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.faceboo...
Sep 19, 2021•26 min•Ep. 112
When we order liver function tests (or “LFTs”) we get the blood levels of 4 liver enzymes: AST, ALT, GGT and ALP. Often the way they become elevated in pairs, helps us work out where the problem is.
Sep 15, 2021•8 min•Ep. 111
Nephritic syndrome is a collection of signs and symptoms that can result from glomerular capillary damage. It classically presents with an abrupt onset of macroscopic haematuria, elevated blood pressure, acute kidney injury and/or generalised oedema. It isn't a diagnosis in itself, meaning that further investigations need to be done. In this episode, we explore the causes of nephritic syndrome, investigations to consider in order to help figure out what the aetiology is, and general management p...
Sep 12, 2021•16 min•Ep. 110
Hydration status is an important part of assessing any child. Kids often fall behind on their fluid intake when they are unwell, and it is important to be able to assess and decide whether a patient needs intervention from a hydration perspective. Although weight (loss) is the gold standard in assessing, where we treat any weight loss from a pre-morbid weight taken within the last 2 weeks as water loss, this information is often unavailable. This means that clinical assessment and estimation is ...
Sep 09, 2021•8 min•Ep. 109
Inflammatory bowel disease (or IBD) is an autoimmune disease that causes chronic inflammation of the gastrointestinal tracts. It is characterised by relapsing episodes of abdominal pain and diarrhoea, systemic features such as fatigue, fever and weight loss, as well as extraintestinal features. There are two main types of IBD: Ulcerative Colitis and Crohn’s Disease. Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email...
Sep 05, 2021•20 min•Ep. 108
Cyclic vomiting syndrome is characterised by recurrent episodes of profuse vomiting separated by asymptomatic periods. The average age of onset is 5-6 years old. Presentation: Often the vomiting spells are quite sudden onset The child may get a prodrome e.g. a smell or taste or funny feeling before the vomiting starts The vomiting is quite intense - often around 12-15 vomits a day while they are happening. Typically bouts last 24-48 hours Links and resources: Follow us on Instagram @yourekidding...
Sep 02, 2021•8 min•Ep. 107
Nephrotic syndrome is characterised by proteinuria, hypoalbuminaemia and oedema. Most cases are idiopathic, however there are some other causes and associations such as respiratory infections and minimal change disease. There are several possible complications of nephrotic syndrome, including intravascular volume depletion, severe oedema, and an increased risk of infections. In this episode about nephrotic syndrome, we discuss the presentation, pathophysiology, causes, investigations, management...
Aug 29, 2021•18 min•Ep. 106
Chorioamnionitis, now called intra-amniotic infection (although it is still widely referred to as chorioamnionitis), is a bacterial infection of the chorion, amnion, amniotic fluid, placenta, or a combination of these. It is generally caused by a prolonged rupture of membranes, and can be potentially very serious for both the person giving birth, and the baby. Chorioamnionitis is the most common cause of peripartum infection in the person giving birth, and is most common in those delivered prete...
Aug 26, 2021•8 min•Ep. 105
Spina bifida is a type of neural tube defect. It is caused by an incomplete closing of the embryonic neural tube. The vertebrae overlying the neural tube defect do not become fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to herniate through the opening in the bones. Although the cause is not known, low folate levels during pregnancy increase risk. Some children are asymptomatic, and others have severe neurologic dysfunction bel...
Aug 22, 2021•21 min•Ep. 104
Anyone who works in paediatrics or alongside paediatric teams will know the importance of a urine sample in kids. Following on from our episodes on interpreting urine dipstick and MCS results, as well as urinary tract infections, this episode describes the different ways to collect urine in children and the methods for each. Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yourekiddingright...
Aug 12, 2021•11 min•Ep. 103
Alpha-1 antitrypsin (A1AT) deficiency is a genetic disorder affecting predominantly the lungs and liver. Although it is considered uncommon, there is some evidence to suggest it is under recognised and under diagnosed. A1AT itself is a protease inhibitor that helps protect the lung and other tissues. Liver disease is more likely to be the predominant presenting feature in kids, but many people with A1AT enter adulthood without a diagnosis. Links and resources: Follow us on Instagram @yourekiddin...
Aug 09, 2021•19 min•Ep. 102
Food Protein Induced Enterocolitis (or FPIES) is a non-IgE mediated food hypersensitivity that presents with vomiting and looking very unwell, later often followed by diarrhoea. Most cases occur in under 12 month olds. Usually children present with profuse vomiting about 1-3 hours post ingestion of the trigger food. They often look very unwell and become lethargic, floppy and pale for a period of time! 5-10 hours after ingestion they often develop diarrhoea (which may be bloody). Follow us on In...
Aug 04, 2021•6 min•Ep. 101
Urinary tract infections (UTIs) are an important differential diagnosis in the febrile child. In younger children, they may present with nonspecific symptoms like fever and vomiting, lethargy and a range of other features. In this episode, we go through the presentation, when to investigate further with items such as an ultraound, usual causative pathogens, management and more. Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingri...
Aug 01, 2021•18 min•Ep. 100
Osteogenesis Imperfecta is a congenital disorder characterised by brittle bones that are prone to fracture and other features like blue sclera , hearing impairment and discoloured teeth. It is caused by defective collagen synthesis (specifically type 1 collagen). There are many different subtypes of OI and the range of clinical features and severity is vast. There is no cure but treatment may involve medications like bisphosphonates and growth hormone, surgery to fix or prevent fractures or fix ...
Jul 28, 2021•17 min•Ep. 99
Urinary tract infections are a major differential for any child presenting with a fever. Thus, urine specimen collection is an important part of the workup of the febrile child. In this episode, we discuss the two main tests performed on urine in this setting. Firstly, there is the "urine dipstick", also known as a full ward test. The two main important items on this are the nitrites and leucocytes. Secondly, there is the microscopy, culture and sensitivities, which confirms diagnosis but also g...
Jul 25, 2021•10 min•Ep. 98
Eosinophilic oesophagitis (or EoE) is caused by an immune response to dietary antigens. It can cause symptoms like chest pain, vomiting and dysphagia. Untreated, chronic oesophageal inflammation can ultimately lead to oesophageal narrowing and strictures. Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yourekiddingrightpod@gmail.com Make sure you hit SUBSCRIBE/FOLLOW so you don’t miss out on any pearls of wisd...
Jul 21, 2021•9 min•Ep. 97
Mycobacterium tuberculosis has overtaken HIV/AIDS as the leading cause of death from infectious disease in the world, according to the WHO. One third of the global population is infected, including those with latent disease. In this episode, we discuss the presentation of tuberculosis, screening tests, definitive diagnosis, and management. Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yo...
Jul 18, 2021•22 min•Ep. 96
Epiglottitis is a life threatening inflammation of the epiglottis, classically caused by Haemophilus influenzae (Hib), but other pathogens can cause it too, and should especially be considered if an immunised individual presents with epiglottitis. The most important thing initially is to avoid distressing the child, as this could worsen airway obstruction. It is an emergency and requires early escalation in order to secure an airway. Listen in to find out more about the presentation, management ...
Jul 14, 2021•8 min•Ep. 95
Wilms tumour (also known as nephroblastoma) is a type of kidney cancer than mostly affects children. It mostly occurs in kids under 5. Often the child seems well at diagnosis and it is only picked up because someone notices a lump in their tummy. Treatment usually involved surgery to remove the entire kidney that has the tumour, and then chemotherapy to make sure there are no remnants of the tumour left. Overall the survival rates are good. Follow us on Instagram @yourekiddingrightdoctors Facebo...
Jul 12, 2021•12 min•Ep. 94
Beckwith-Wiedemann syndrome is the most common paediatric overgrowth and cancer predisposition disorder. It is a genetic condition presenting with a wide range of symptoms and signs. Sometimes it is referred to as exomphalos-macroglossia-gigantism syndrome. Individuals with BWS are at increased risk of developing embryonal cancers, with the most common one being Wilms tumour. In this episode, we go through through the presenting features, along with the various oncological associations and summa...
Jul 08, 2021•21 min•Ep. 93
Neonatal abstinence syndrome describes drug withdrawal signs in newborn babies after they have been exposed to certain medications in utero, typically opioids. Babies can go through withdrawal after birth when they are no longer being exposed to the substance in the maternal circulation via the placenta. Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yourekiddingrightpod@gmail.com Make sure you hit SUBSCRIBE/...
Jul 07, 2021•8 min•Ep. 92
Following on from our episode on meningococcal, we bring you a guide to interpreting cerebrospinal fluid (CSF) results - once you've gotten some CSF from that hopefully champagne tap! (A champagne tap meaning a perfectly clear tap that isn't contaminated by red cells!) In this episode, we go through what's normal in CSF, and a guide as to what should prompt the practitioner to think of bacterial vs. viral causes. Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: htt...
Jun 30, 2021•8 min•Ep. 91
Cystic fibrosis is an autosomal recessive disorder that affects many organ systems, particularly the respiratory and digestive systems. It causes thick secretions which block ducts and airways. It is most common in people of northern european descent. It is a life limiting disorder but huge advances in treatment have been made and life expectancy is increasing to many times what it used to be. The biggest cause of mortality is respiratory failure. Follow us on Instagram @yourekiddingrightdoctors...
Jun 27, 2021•20 min•Ep. 90
A “pulled elbow” (sometimes called a nursemaid’s elbow) is subluxation of the radial head at the elbow (or, if you are being very technical, subluxation of the annular ligament). It usually occurs in kids aged 1-4. The name pulled elbow literally describes the mechanism of injury in most cases - typically it’s a child who is about to run onto a road or fall or something and someone grabs their hand and pulls, or when you are lifting a child up by the hands - and POP you’ve got a subluxation that...
Jun 23, 2021•6 min•Ep. 89
Meningococcal disease is caused by Neisseria meningitidis, a gram negative diplococcus. The two most common presentations of meningococcal infection are meningococcal meningitis and meningococcaemia. An individual may present with one or both of these. Rapid recognition and treatment is vital, requiring IV antibiotics, but even with treatment, up to 15% of cases result in fatality. Listen in to find out more about meningococcal! Links and resources: Follow us on Instagram @yourekiddingrightdocto...
Jun 21, 2021•22 min•Ep. 88
Costochondritis is a common cause of chest pain in children and adolescents. It is inflammation of 2-4 consecutive costochondral or costosternal junctions. Follow us on Instagram @yourekiddingrightdoctors (This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)
Jun 16, 2021•10 min•Ep. 89
Nitrous oxide is a common choice for procedural sedation, for its rapid onset and offset and combination of sedation, anxiolysis, amnesia and some level of analgesia. It's great for short procedures like cannulas or suturing. In this episode, we will go through the use of nitrous oxide, common side effects, contraindications to be aware of, and proposed mechanisms of action. Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingright...
Jun 13, 2021•13 min•Ep. 88
Epistaxis is the medical term for a nosebleed. This is a common occurrence in kids, and is usually due to a combination of nasal mucosa, plus trauma like picking and the effects of drying from the air around us. They usually don't need to be investigated, unless they occur often, are resistant to basic measures or there if there are other red flags - which we will discuss further in this episode! Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook...
Jun 09, 2021•12 min•Ep. 87
Spinal Muscular Atrophy, or SMA, is a genetic disorder where nerve cells in the spinal cord die prematurely, and this causes the muscles that would normally be controlled by those nerves to atrophy. The most common subtype usually presents in the first 6 months of life with a hypotonic baby (and other lower motor neuron signs). Typically these children die before 2 years of age, mostly from respiratory failure. There are some new treatments being developed including one currently available on th...
Jun 06, 2021•22 min•Ep. 86
SIDS is classified as a sudden and unexplained death of an infant in their first year of life. It is a diagnosis of exclusion - an autopsy must be done and all other causes ruled out. Before safe sleeping campaigns in the 1990s, the prevalence of SIDS was about 1.5 in 1000 babies. Now it is about 0.5 in 1000. From 1989 to 2018, the rate of SUDI deaths in Australia has decreased by 85% – equating to 10,857 babies saved since risk reduction campaigns were introduced
Jun 02, 2021•9 min•Ep. 85
