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!

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

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, investigations to consider in order to help figure out what the aetiology is, and general management principles. 

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

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 vital. In this episode, we run through what to look for as part of a hydration assessment. 

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

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.

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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

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

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 and more.

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

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 preterm. Tune in to this episode to hear more about the presentation, pathophysiology, common pathogens, management and more!

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

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 below the lesion.

It can be diagnosed prenatally by ultrasonography or suggested by elevated alpha-fetoprotein levels in maternal serum. Treatment is usually surgical although it is not curative.

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

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. 

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(This isn’t individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)