You're Kidding, Right?

Tumour lysis syndrome is an oncologic emergency. It happens when cancer cells release their intracellular contents into the bloodstream which can cause a variety or serious complications.  Follow us on Instagram @yourekiddingrightdoctors Our email is yourekiddingrightpod@gmail.com Make sure you hit SUBSCRIBE/FOLLOW so you don't miss out on any pearls of wisdom and RATE if you can to help other peo...

IgA nephropathy is a cause of glomerulonephritis and is the most common chronic glomerular disease in children. Like the name suggests, it is characterised by kidney damage due to IgA (an immunoglobulin) which deposits in complexes in the kidney. The classic presentation is recurrent episodes of macroscopic haematuria a couple of days after the onset of an URTI. About 25% of children will eventual...

Charcot-Marie-Tooth disease is a peripheral neuropathy i.e. it affects the nerves of the peripheral nervous system. This results in motor and sensory deficits. It's inherited although there are many potential causative mutations. The disease is progressive, but very slowly. Most patients have a normal life expectancy. Follow us on Instagram @yourekiddingrightdoctors Our email is yourekiddingrightp...

In a lumbar puncture (LP), a needle is inserted into the lumbar subarachnoid space to collect cerebrospinal fluid (CSF) for laboratory testing, to measure CSF pressure, and sometimes to give intrathecal medications. Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yourekiddingrightpod@gmail.com Make sure you hit...

Haemolytic uraemic syndrome is one of the most common causes of acute renal failure in children. The classic triad of HUS includes haemolytic anaemia, low platelet count and acute kidney injury. It is most often triggered by recent gastroenteritis from Shiga-like toxin producing E. coli. Management is largely supportive, focusing on managing hypertension, transfusion of blood products as required,...

Congenital dermal melanocytosis (also known as blue spots, or by the outdated term "Mongolian blue spots") are common birth marks in infants of Asian and Polynesian descent, but can be found in other ethnic groups too. They are less common in Caucasian infants.  They can be mistaken for bruises, raising concerns around non accidental injury, which makes them vital to be recognised and documented c...

Hepatitis C is an RNA virus that causes acute and chronic viral hepatitis by being directly toxic to hepatocytes. Most people with acute hepatitis C will go on to develop chronic hepatitis C. The main complications of chronic Hep C are cirrhosis and hepatocellular carcinoma. In Australia, most people acquire hep C through IVDU but in the paediatric population, most acquire it through childbirth. T...

Respiratory illnesses, especially viral illnesses and asthma, are common in children, and assessing work of breathing is a vital part of providing care to these children.  In this episode, we go through what to look for when assessing work of breathing. Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our...

Content warning: non-accidental injury of children is a highly distressing concept and occurrence. We encourage listener discretion prior to listening.  In this episode, we discuss the assessment of injuries in children, and determining which injuries are more likely to be as a result of an accident, vs intentional harm. We go through characteristics of burns, fractures and bruises that may be sus...

Okay so we had a recent episode about the enzymes ALT, AST, GGT and ALP that we get when we order liver function tests and how we interpret them. While that is useful to help us narrow down what is going on with the patient, there are some other results that give us important information about how the liver is functioning. Today we will talk about bilirubin, albumin and coags.  Follow us on Instag...

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 understand...

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. 

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, in...

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...

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 @youreki...

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 h...

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...

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...

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 pregna...

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 Fa...

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 wi...

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...

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 resource...

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 invo...

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 leucocyte...