You're Kidding, Right?

The age at which a person becomes an 'adult' in Australia is 18 years. Consent for the medical treatment of patients less than 18 years of age is generally provided by parents. However, there are circumstances in which patients under the age of 18 can consent to their own medical treatment, which we will talk about in this episode! Follow us on Instagram @yourekiddingrightdoctors Facebook: https:/...

Osteomyelitis is more common in children than it is in adults. Although it can present quite subtly to begin with, it is an important differential to keep in mind. The median age of affected children is 6 years, and cases are usually haematogenous in origin.  Antibiotics are the mainstay of treatment, but in some cases, surgical debridement or even amputation may be required, usually in missed or...

Hydrocoeles in babies are a common finding - up to 1 in 10 boys have one at birth! The pathogenesis is similar to that of inguinal hernias - the failure of the processus vaginalis to close following the descent of the testes. However in hydrocoeles, only fluid descends through the processus vaginalis, no other abdominal content.    Most of the time, hydrocoeles will resolve on their own, but the l...

Idiopathic intracranial hypertension (IIH, occasionally called pseudotumour cerebri or benign intracranial hypertension) is a condition characterised by features of raised intracranial pressure without any other cause identified. The main complication is progressive vision loss.  In this episode we discuss presentation, diagnosis and treatment. Follow us on Instagram @yourekiddingrightdoctors Face...

We use midazolam a lot for procedural sedation in kids. It is a benzodiazepine medication. It has sedative, anxiolytic and amnesic effects - i.e. if it works well, it usually makes the patient a bit sleepy, less anxious, and they often don't remember the procedure. It does NOT have analgesic effects, so you will often use some kind of analgesia for painful procedures.  Tune in to learn more about...

Constipation is a very common presentation in children - 1 in 3 children will have constipation at some point. Most kids pass a soft bowel action at least once every 2-3 days.  Most cases of constipation are functional constipation, but there are a number of important differentials to consider. Treatment takes at least as long as the child has been constipated and requires a multi step approach to...

Inguinal hernias are an important differential for hydrocoeles in baby boys - but don't be fooled, they do less commonly occur in girls too. They are caused by a persistent processus vaginalis, which usually closes in the 28th week of gestation once the testes have gone through in boys. Every patient with an inguinal hernia requires review by a paediatric surgeon as management is operative - eithe...

Acute lymphoblastic leukaemia is the most common childhood cancer. It is a blood cancer in which the cells that normally develop into lymphocytes mutate and become cancerous and rapidly replace normal cells in the  bone marrow. People may have symptoms, such as fever, weakness, and paleness, because they have too few normal blood cells. Full blood count and film and a bone marrow evaluation are do...

The glasgow coma scale is used all the time to assess the level of consciousness of a patient (especially for those with acute head injury). We give a patient a score out of 15 depending on their motor response, their verbal response and the eye response. There are 6 possible points for motor, 5 for voice and 4 for eyes. The higher the score, the better the level of consciousness in the patient. T...

Pertussis, also known as whooping cough and the 100 day cough, is caused by a bacterial infection. The usual pathogen is Bordetella pertussis, but can also be Bordetella parapertussis. Vaccinations worldwide have overall decreased mortality – prior to vaccination, pertussis was the leading cause of death from communicable disease among US children

Bradycardia during sleep is a physiological phenomenon related to increased vagal tone. In the absence of red flags, it does not require investigation.    You don't want to miss: Why bradycardia in sleep happens Explaining the condition to families Red flags to watch for and when to investigate   Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.c...

Phenylketonuria (PKU) is the most common inborn error of metabolism. It is an autosomal recessive condition caused by a disorder of metabolism of an amino acid called phenylalanine. It leads to build up of phenylalanine  in the body which can have serious effects on brain development. Children with PKU can grow and develop normally, if they are carefully monitored and given a diet low in phenylala...

Intraosseous access is a type of vascular access that you get through inserting the needle directly into the bone, aiming for the medullary cavity. You get IO access as an alternative to  Intravenous access in situations where IV access is not practical or will take too long e.g. a shocked patient who is peripherally shut down. The bone is luckily a non collapsible option! Follow us on Instagram @...

Gastro-oesophageal reflux is a common, almost expected, phenomenon in babies, and usually resolves by 18 months of age. Although babies may posset (fancy word for a small vomit) frequently, they still gain weight and look like happy, healthy babies.    Conversely, gastro-oesophageal reflux disease is where the reflux has gone a step further, and complications such as poor growth and oesophagitis h...

Growing pains are the most common cause of recurrent musculoskeletal pain in children. It affects 10–20% of children, with peak incidence between age 4 and 12 yr. It's important to be aware of red flags in presentation that should make you consider other differentials. Links and resources: Follow us on Instagram @yourekiddingright.pod Facebook: https://www.facebook.com/yourekiddingrightpod-1072736...

Neurofibromatosis type 1 is an autosomal dominant disorder associated with benign and occasionally malignant nerve tumours. NF1 is caused by a gene mutation on chromosome 17 which encodes neurofibromin. NF1 is associated with optic nerve tumours, neurofibromas, freckling of the groin and axilla, cafe au lait spots, skeletal abnormalities and lisch nodules in the iris.  You don't want to miss: A ca...

Summary:  Colic is an outdated term for a normal developmental stage in an infant's life. The acronym PURPLE crying describes the features Peak of crying – peak at 2 months, less in months 3-5, Unexpected, Resists soothing,   Pain-like face, Long lasting, and Evening.    Although a normal phenomenon for infants, PURPLE crying is highly distressing for parents and therefore it is vital to check in...

Summary:  DiGeorge syndrome is a genetic condition caused by the deletion of a chunk of genes on chromosome 22 (specifically the q11.2 region). The classic triad of DiGeorge syndrome is cardiac anomalies, underdeveloped thymus gland and hypocalcaemia (secondary to underdevelopment of the parathyroid glands). The phenotype of DiGeorge syndrome is related to abnormal development of the embryonic pha...

Developmental milestones are a huuuuge part of general paediatrics. Briefly, developmental milestones are a set of skills that most infants will attain by a certain age. They can be broadly categorised into gross motor, fine motor, language and social. Today we will discuss what milestones 6 week olds should be attaining, plus we will also touch on typical feeding, sleep, wet and dirty nappies, gr...

With special guest - Alice Bleathman, dietitian Coeliac disease is an immune-mediated disorder where gluten in food triggers an immune response that results in damage to the small intestine. The presentations varies but often includes poor growth, gastrointestinal symptoms and micronutrient deficiencies from malabsorption. You don't want to miss: A case Differentials for chronic diarrhoea Explaini...

HEEADSSS (with a varying number of Es and Ss according to locality) is a framework to help clinicians take a psychosocial interview, usually from an adolescent. It assists us in treating an adolescent patient within their wider context, screening for a range of items from mental health to risks to the individual, both from self and externally.  You don't want to miss: Tips to help you hone your ge...

Hirschprung's Disease, sometimes called congenital aganglionic megacolon, is the most common cause of neonatal bowel obstruction. It is due to an absence of ganglion nerve cells in the lower bowel. The absence of these cells leads to abnormal peristalsis so the aganglionic portion doesn't relax properly, effectively causing an obstruction.  You don't want to miss: A case Differentials for neonatal...

The Newborn Screening Test is a quick, safe and effective way to identify babies at risk of certain serious conditions. Screening is the only way to identify affected babies early as there may be no signs or symptoms of illness at birth. By the time affected babies show symptoms, their development or health may already be impaired. Early diagnosis allows early treatment or management to prevent or...

G6PD deficiency is a genetic disorder where the body doesn't have enough G6PD (aka glucose-6-phosphate dehydrogenase) which usually functions to protect the red blood cells from normal oxidative stress. Without enough protective G6PD, the red cells haemolyse, mostly in response to certain triggers like viral illness and certain foods and medications. There is no cure for G6PD but most people with...

Impetigo is a common bacterial skin infection, characterised by blisters or vesicles which then rupture and develop a crusted lesion. It is also known as school sores, as it is so common in kids and spreads like wildfire amongst classes if not treated and general measures taken to prevent spread.    It is caused by staphylococcus and group A streptococcus. Although impetigo is usually very respons...