TAILIEUCHUNG - Recognising Cardiac Disease in Children

This argument forms an important facet of what is usually referred to as parental investment (PI) theory, a subset of life history theory. To test the hypothesis that parents experiencing resource constraints will invest differentially in offspring, and that the patterns of investment accord with PI theory, a number of health, nutrition and social variables were measured for all children between the ages of 5 and 15 living in a Yanomamö village on the Upper Orinoco River in southern Venezuela. The Yanomamö are Native American swidden horticulturists living in the tropical forests of southern Venezuela and northern Brazil. They number approximately 15–20,000, and live in 200–250 widely scattered. | Recognising Cardiac Disease in Children Name Elizabeth Storey Hospital Leeds Teaching Hospitals UK E-mail kate@ Consider the following 2 cases and discuss the questions below before reading the tutorial. Case A A 3 month old baby presents with poor feeding and failure to thrive. She was born at term after a normal pregnancy. Mum describes that the baby always breathes very fast that she takes a long time to feed and gets very sweaty. On examination the baby is pink malnourished and breathless. She has a respiratory rate of 50 and has marked intercostal and sub-costal recession. She has a loud pan-systolic murmur and her liver is palpable at 2cm. A CXR shows increased pulmonary vascular markings and a large heart 60 of the thoracic diameter . Case B A 9 year old girl presents with fever and chest pain. Her mother informs you that she had a sore throat a few weeks ago for which she did not receive any treatment. On examination you notice that her right knee and left elbow are swollen and painful. On auscultation of her heart you hear a loud pansystolic murmur. Questions 1. What is meant by cyanotic or acyanotic cardiac lesions List example of each. 2. What is Eisenmengers syndrome 3. What is meant by duct dependence 4. How can you recognise cardiac disease in children 5. What is the likely diagnosis for case A and where does it fit into your classification 6. List as many different cardiac lesions as you can think of and describe the type and location of the murmur associated with it eg aortic stenosis ejection systolic murmur upper right sternal edge. 7. Describe how you would systematically look at a paediatric CXR and some of the features you may be looking for in cardiac disease. 8. What investigations if available could help you to identify cardiac disease 9. What is the diagnosis for case B and what is the likely cause of the heart murmur How many children worldwide do you think are affected with this condition 10. What are the features of an .

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