Comprehensive Pediatrics Glossary

O

Definition: Excessive body fat accumulation affecting health; BMI ≥95th percentile for age and sex.
Etiology: Multifactorial – genetic predisposition, poor diet, sedentary lifestyle, endocrine disorders (hypothyroidism, Cushing syndrome).
Clinical Features: Increased BMI, acanthosis nigricans, early puberty in girls, orthopedic complications (genu valgum, flat feet), psychosocial issues.
Investigations: BMI-for-age charts, fasting glucose, lipid profile, liver function tests, thyroid function.
Management: Lifestyle modification (diet, physical activity), behavioral therapy, pharmacotherapy in selected cases (orlistat), bariatric surgery for severe adolescent obesity.
Complications: Type 2 diabetes, dyslipidemia, hypertension, sleep apnea, NAFLD, psychosocial disorders.

Definition: Infection or inflammation of the middle ear.
Types:
- Acute otitis media (AOM) – rapid onset, often bacterial.
- Otitis media with effusion (OME) – fluid without acute infection.
Etiology: Bacterial: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis; viral causes also common.
Clinical Features: Ear pain, fever, irritability, hearing loss, sometimes otorrhea if perforated tympanic membrane.
Investigations: Otoscopic examination, tympanometry, audiometry for chronic cases.
Management:
- AOM: Analgesics, antibiotics if indicated (amoxicillin first-line).
- OME: Observation, tympanostomy tubes if persistent or causing hearing loss.
Complications: Chronic otitis media, hearing impairment, mastoiditis, intracranial infections (rare).

Definition: Genetic disorder characterized by brittle bones due to defective collagen type I synthesis.
Clinical Features: Frequent fractures, blue sclera, dentinogenesis imperfecta, short stature, hearing loss.
Investigations: Genetic testing (COL1A1/COL1A2 mutations), radiographs showing osteopenia and fractures at different healing stages.
Management: Fracture management, bisphosphonates for bone density, physical therapy, surgical interventions (rods).
Complications: Recurrent fractures, deformities, hearing loss, reduced quality of life.

Definition: Infection of the bone, commonly bacterial.
Etiology: Staphylococcus aureus (most common), Streptococcus pyogenes, Gram-negative bacteria.
Clinical Features: Fever, localized pain, swelling, warmth, limited limb movement.
Investigations: CBC, ESR/CRP, blood cultures, X-ray (early: may be normal), MRI (sensitive for early changes).
Management: Empirical IV antibiotics adjusted based on culture, surgical drainage if abscess forms.
Complications: Chronic osteomyelitis, growth plate damage, sepsis.

Definition: Reduced bone mass and structural deterioration increasing fracture risk.
Etiology: Primary (genetic), secondary (chronic illness, steroid use, malnutrition, endocrine disorders).
Clinical Features: Fractures with minimal trauma, back pain, kyphosis, growth retardation.
Investigations: DEXA scan, serum calcium, phosphate, vitamin D, PTH, bone turnover markers.
Management: Treat underlying cause, calcium and vitamin D supplementation, bisphosphonates for severe cases, weight-bearing exercise.

Definition: Infection of the umbilical stump in newborns.
Etiology: Bacterial – Staphylococcus aureus, E. coli, Group B Streptococcus.
Clinical Features: Redness, swelling, discharge from umbilicus, foul odor, systemic signs (fever, lethargy) in severe cases.
Investigations: CBC, blood culture, umbilical swab culture.
Management: IV antibiotics for systemic infection, local hygiene, surgical intervention if abscess forms.
Complications: Sepsis, necrotizing fasciitis, omphalomesenteric duct anomalies if underlying.

Definition: Conjunctivitis occurring in the first 4 weeks of life.
Etiology: Bacterial: Neisseria gonorrhoeae, Chlamydia trachomatis; chemical irritation from prophylaxis.
Clinical Features: Redness, purulent discharge, eyelid swelling.
Investigations: Gram stain, culture of conjunctival swab.
Management:
- Gonococcal: IV/IM ceftriaxone.
- Chlamydial: Oral erythromycin.
Prevention: Routine neonatal prophylaxis (erythromycin eye ointment).

Definition: Infection/inflammation of the external auditory canal (“swimmer’s ear”).
Etiology: Bacterial (Pseudomonas, Staphylococcus aureus), fungal in rare cases.
Clinical Features: Ear pain, itching, discharge, swelling, tenderness on tragus manipulation.
Investigations: Clinical diagnosis, culture if recurrent or severe.
Management: Topical antibiotics (with/without corticosteroids), analgesics, keep ear dry.
Complications: Malignant otitis externa in immunocompromised children (rare).

Definition: Recurrent upper airway obstruction during sleep causing intermittent hypoxia and sleep fragmentation.
Etiology: Adenotonsillar hypertrophy (most common), obesity, craniofacial anomalies, neuromuscular disorders.
Clinical Features: Snoring, restless sleep, daytime sleepiness, behavioral problems, growth failure.
Investigations: Polysomnography (gold standard), ENT examination, sleep questionnaires.
Management: Adenotonsillectomy for adenotonsillar hypertrophy, CPAP in selected cases, weight management, orthodontic interventions for craniofacial anomalies.
Complications: Cardiopulmonary sequelae, behavioral and cognitive deficits, growth retardation.

Definition: Focal separation of articular cartilage and underlying subchondral bone.
Etiology: Repetitive trauma, ischemia, genetic predisposition.
Clinical Features: Joint pain, swelling, locking or catching of joint (commonly knee, ankle, elbow).
Investigations: X-ray, MRI (to assess cartilage and bone viability).
Management: Rest, activity modification, physiotherapy, surgical fixation or removal if loose body present.

Definition: Low amniotic fluid volume (<5th percentile for gestational age).
Etiology: Fetal renal anomalies, placental insufficiency, post-term pregnancy, ruptured membranes.
Clinical Features: In utero: decreased fetal movement, abnormal growth; neonatal: pulmonary hypoplasia, limb deformities.
Investigations: Ultrasound (AFI or MVP measurement), fetal monitoring.
Management: Treat underlying cause, amnioinfusion during labor if indicated, neonatal supportive care.

Bookmark