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Comprehensive Pediatrics Glossary

H

Hand-Foot-and-Mouth Disease (HFMD)

  • Definition: A common viral illness in children caused by enteroviruses (most commonly coxsackievirus A16 and enterovirus 71).

  • Clinical Features:

    • Fever, malaise, sore throat.

    • Painful vesicular lesions on hands, feet, and oral mucosa.

    • Occasional nail shedding (onychomadesis).

  • Complications: Dehydration due to painful oral ulcers; rare neurological complications with enterovirus 71.

  • Management: Supportive: hydration, analgesics, antipyretics.

  • Prevention: Good hygiene, isolation during illness.

Hemangioma (Infantile)

  • Definition: Benign vascular tumor of infancy.

  • Epidemiology: More common in females; usually appears within first weeks of life.

  • Clinical Features: Red to purple raised lesion; may proliferate for first 6–12 months, then involute.

  • Complications: Ulceration, bleeding, obstruction depending on location (ocular, airway).

  • Management: Observation for most; beta-blockers (propranolol) for problematic lesions, laser therapy in select cases.

Hemophilia

  • Definition: X-linked recessive bleeding disorder caused by deficiency of clotting factors (A – factor VIII; B – factor IX).

  • Clinical Features:

    • Easy bruising, prolonged bleeding after minor trauma, hemarthroses, muscle hematomas.

  • Investigations: Prolonged activated partial thromboplastin time (aPTT), normal PT, factor assays.

  • Management:

    • Replacement therapy with factor concentrates.

    • Desmopressin for mild hemophilia A.

    • Preventive physiotherapy for joints.

  • Complications: Hemophilic arthropathy, intracranial hemorrhage.

Henoch-Schönlein Purpura (HSP)

  • Definition: IgA-mediated small vessel vasculitis in children.

  • Epidemiology: Most common vasculitis in children aged 3–15 years.

  • Clinical Features:

    • Palpable purpura (lower limbs, buttocks).

    • Arthralgia/arthritis.

    • Abdominal pain, GI bleeding.

    • Renal involvement (hematuria, proteinuria).

  • Investigations: Urinalysis, renal function tests, skin biopsy if atypical.

  • Management: Supportive; corticosteroids for severe abdominal or renal involvement.

  • Prognosis: Usually self-limiting; renal involvement dictates long-term outcomes.

Hearing Loss (Pediatric)

  • Types:

    • Conductive: Otitis media, tympanic membrane perforation.

    • Sensorineural: Genetic causes, infections (CMV), noise exposure.

  • Clinical Features: Delayed speech, inattentiveness, poor academic performance.

  • Investigations:

    • Newborn hearing screen.

    • Audiometry, tympanometry, ABR (auditory brainstem response).

  • Management:

    • Treat underlying cause.

    • Hearing aids or cochlear implants for sensorineural loss.

    • Early speech and language therapy.

Heart Murmurs (Pediatric)

  • Definition: Audible sounds during cardiac auscultation caused by turbulent blood flow.

  • Types:

    • Innocent (physiologic): Soft, systolic, changes with position.

    • Pathologic: Associated with structural heart disease.

  • Common Causes:

    • Congenital: VSD, ASD, PDA, tetralogy of Fallot.

    • Acquired: Rheumatic heart disease, endocarditis.

  • Investigations: Echocardiography, ECG, chest X-ray.

  • Management: Depends on etiology: observation, medical therapy, or surgical correction.

Hemolytic Disease of the Newborn (HDN)

  • Definition: Hemolysis of fetal red blood cells due to maternal alloimmunization (Rh or ABO incompatibility).

  • Clinical Features: Jaundice, anemia, hepatosplenomegaly, hydrops fetalis in severe cases.

  • Investigations: Direct Coombs test, bilirubin, hemoglobin, reticulocyte count.

  • Management:

    • Phototherapy, exchange transfusion for severe hyperbilirubinemia.

    • Prevention with antenatal anti-D immunoglobulin for Rh-negative mothers.

Hemolytic Uremic Syndrome (HUS)

  • Definition: Triad of acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia, commonly post-diarrheal (Shiga toxin-producing E. coli).

  • Clinical Features: Pallor, edema, hematuria, oliguria, hypertension.

  • Investigations: CBC (anemia, thrombocytopenia), peripheral smear (schistocytes), renal function tests, stool culture for E. coli O157:H7.

  • Management: Supportive: fluid management, dialysis if necessary; avoid antibiotics for Shiga toxin-producing E. coli.

  • Prognosis: Most recover renal function; chronic kidney disease is a potential complication.

Hip Dysplasia (Developmental Dysplasia of the Hip – DDH)

  • Definition: Abnormal development of the hip joint leading to instability or dislocation.

  • Risk Factors: Breech presentation, family history, female sex, oligohydramnios.

  • Clinical Features:

    • Limited abduction, asymmetric thigh folds, leg length discrepancy.

    • Positive Ortolani or Barlow maneuvers in neonates.

  • Investigations: Ultrasound (infants <6 months), X-ray (older infants).

  • Management: Pavlik harness for infants <6 months; surgery for persistent/dislocated hips.

Hydrocephalus

  • Definition: Accumulation of cerebrospinal fluid (CSF) in the ventricles causing increased intracranial pressure.

  • Etiologies:

    • Congenital: aqueductal stenosis, spina bifida.

    • Acquired: intraventricular hemorrhage, infections, tumors.

  • Clinical Features: Macrocephaly, bulging fontanelle, vomiting, irritability, developmental delay.

  • Investigations: Ultrasound (neonates), CT/MRI brain.

  • Management:

    • Surgical: ventriculoperitoneal shunt, endoscopic third ventriculostomy.

    • Supportive: monitor head circumference, manage complications.

Hyperbilirubinemia (Neonatal)

  • Definition: Elevated serum bilirubin in newborns.

  • Types:

    • Physiologic: Peaks at 3–5 days, resolves spontaneously.

    • Pathologic: Appears within 24 hours, rises rapidly, or persists >2 weeks.

  • Causes: Hemolysis, infection, G6PD deficiency, biliary obstruction.

  • Clinical Features: Jaundice, lethargy, poor feeding.

  • Investigations: Total and direct bilirubin, blood group typing, Coombs test.

  • Management:

    • Phototherapy, exchange transfusion for severe cases.

    • Treat underlying cause.

Hypernatremia

  • Definition: Serum sodium >145 mmol/L, indicating water deficit relative to sodium.

  • Etiology: Dehydration, diabetes insipidus, hypertonic feeds.

  • Clinical Features: Thirst, irritability, lethargy, seizures.

  • Investigations: Serum sodium, urine osmolality, renal function.

  • Management: Gradual correction with hypotonic fluids to avoid cerebral edema.

Hypoglycemia (Pediatric)

  • Definition: Blood glucose <45–50 mg/dL (2.5–2.8 mmol/L) in neonates and <60 mg/dL in older children (variable).

  • Etiology: Neonatal: prematurity, intrauterine growth restriction, sepsis, endocrine disorders.

  • Clinical Features: Jitteriness, lethargy, seizures, poor feeding.

  • Investigations: Blood glucose, serum ketones, insulin, cortisol, growth hormone if persistent.

  • Management: Prompt glucose administration (oral if alert, IV if severe), treat underlying cause.

Hypothyroidism (Congenital and Acquired)

  • Definition: Deficiency of thyroid hormones leading to impaired growth and development.

  • Clinical Features:

    • Neonatal: Lethargy, prolonged jaundice, macroglossia, umbilical hernia.

    • Older children: Growth retardation, delayed puberty, constipation, dry skin.

  • Investigations: TSH, free T4, thyroid antibodies if autoimmune.

  • Management: Lifelong levothyroxine replacement, regular monitoring of growth and development.

 

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