0071643192.pdf

PEDIATRICS

HEARTBLOCK

Heart block is most commonly seen postoperatively following cardiac surgery.

Other causes include rheumatic heart disease, myocarditis, lupus, and

Kawasaki’s disease.

SUPRAVENTRICULARTACHYCARDIA(SVT)

SVT is the most common significant arrhythmia in pediatrics. Most chil-

dren with SVT have a structurally normal heart. Treatment consists of vagal

maneuvers or adenosine, and possible cardioversion if unstable.

PROLONGEDQTSYNDROME

Prolonged QT syndrome can be cause of syncope and/or sudden death.

Bazett’s formula: QT interval divided by the square root of the RR interval. It can

be associated with deafness (Jervell and Lange-Nielson syndrome) or without

deafness(Romano-Ward syndrome). Corrected QTc is usually >0.46 ms but

varies with age. Treatment is with β-blockers and occasionally placement of

pacemaker or ICD device.

DERMATOLOGY

Diaper Dermatitis

The most common etiologies of diaper rash are shown in Table 5.5.

Seborrhea

■ Inflammation due to increased production of sebaceous glands

■ Peak incidence––2 weeks of age

■ Typically resolves spontaneously by 1 year of age

SYMPTOMS/EXAM

Greasy scale accumulation on the face, scalp (“cradle cap”), and sometimes

diaper area (see Figure 5.3)

DIAGNOSIS

Clinical diagnosis

TABLE 5.5. Common Etiologies of Diaper Dermatitis

CHARACTERISTICS TREATMENT

Contact dermatitis Spares deep skin folds Increase frequency of diaper

changes; keep skin clean, dry

Candida albicans Affects deepest skin folds; Topical antifungal

may have satellite lesions

Seborrhea Greasy scale; may have Topical steroid

satellite lesions

Impetigo Yellow crusting Oral antibiotic