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Comprehensive Pediatrics Glossary

V

Varicella (Chickenpox)

  • Definition: Highly contagious viral infection caused by varicella-zoster virus (VZV).

  • Epidemiology: Most common in children <10 years; outbreaks in schools/daycare centers.

  • Clinical Features: Fever, malaise, pruritic vesicular rash progressing from macules → papules → vesicles → crusts, centripetal distribution.

  • Investigations: Clinical diagnosis; PCR or serology rarely needed.

  • Management: Symptomatic: antihistamines for pruritus, antipyretics (avoid aspirin). Antivirals (acyclovir) for high-risk or immunocompromised children.

  • Prevention: Varicella vaccination (2 doses recommended).

  • Complications: Secondary bacterial infection, pneumonia, encephalitis, hemorrhagic varicella.

Ventricular Septal Defect (VSD)

  • Definition: Congenital cardiac defect characterized by an abnormal opening in the interventricular septum, allowing blood to flow from left to right ventricle.

  • Epidemiology: Most common congenital heart defect.

  • Clinical Features: Small defects may be asymptomatic; large defects cause heart failure: tachypnea, poor feeding, failure to thrive, recurrent respiratory infections, systolic murmur at left lower sternal border.

  • Investigations: Echocardiography (diagnostic), ECG, chest X-ray (cardiomegaly, pulmonary plethora).

  • Management: Observation for small VSDs, medical management for heart failure (diuretics, digoxin), surgical closure if large or symptomatic.

  • Complications: Pulmonary hypertension, Eisenmenger syndrome, infective endocarditis.

Viral Exanthems

  • Definition: Generalized rashes caused by viral infections, commonly seen in children.

  • Types and Etiology:

    • Measles – paramyxovirus

    • Rubella – togavirus

    • Roseola (HHV-6/7)

    • Fifth disease (erythema infectiosum, parvovirus B19)

  • Clinical Features: Fever, malaise, characteristic rash distribution and progression.

  • Investigations: Clinical diagnosis; serology/PCR if uncertain.

  • Management: Supportive care: hydration, antipyretics, isolation to prevent spread.

  • Complications: Secondary bacterial infections, encephalitis, thrombocytopenia.

Vitamin D Deficiency

  • Definition: Insufficient vitamin D levels leading to impaired bone mineralization in children.

  • Etiology: Inadequate sunlight exposure, poor dietary intake, malabsorption, chronic liver/kidney disease.

  • Clinical Features: Rickets (bone deformities, delayed growth), hypocalcemic seizures, delayed fontanelle closure.

  • Investigations: Serum 25(OH)D levels, calcium, phosphate, alkaline phosphatase, X-ray of long bones.

  • Management: Vitamin D supplementation (ergocalciferol or cholecalciferol), dietary calcium, treatment of underlying cause.

  • Complications: Skeletal deformities, growth retardation, secondary hyperparathyroidism.

Ventricular Tachycardia (VT) in Children

  • Definition: Rapid heart rhythm originating from the ventricles.

  • Etiology: Structural heart disease, myocarditis, congenital long QT syndrome, post-surgical, idiopathic.

  • Clinical Features: Palpitations, syncope, chest pain, hypotension, heart failure symptoms; may be asymptomatic in mild cases.

  • Investigations: ECG (wide QRS tachycardia), Holter monitoring, echocardiography, electrolyte panel.

  • Management: Acute: antiarrhythmic therapy (amiodarone, lidocaine), cardioversion if unstable; chronic: beta-blockers, implantable cardioverter-defibrillator (ICD) in high-risk cases.

  • Complications: Sudden cardiac arrest, heart failure, syncope.

Varicose Veins (Pediatric)

  • Definition: Dilated superficial veins in the lower extremities due to venous insufficiency.

  • Etiology: Congenital venous malformations, familial predisposition, secondary to other venous anomalies.

  • Clinical Features: Visible dilated veins, leg pain, swelling, cosmetic concern, fatigue in lower limbs.

  • Investigations: Clinical examination, Doppler ultrasonography.

  • Management: Conservative (compression stockings, leg elevation, physical activity), surgical or endovascular intervention for severe cases.

  • Complications: Thrombophlebitis, ulceration, chronic venous insufficiency.

Viral Hepatitis (Pediatric)

  • Definition: Liver inflammation due to viral infections, commonly hepatitis A, B, or C.

  • Clinical Features: Fatigue, jaundice, anorexia, vomiting, hepatomegaly, dark urine.

  • Investigations: Liver function tests (AST, ALT, bilirubin), viral serologies (HAV IgM, HBsAg, HCV RNA).

  • Management: Supportive care (hydration, nutrition), antiviral therapy for chronic hepatitis B/C as indicated, vaccination for prevention (HAV, HBV).

  • Complications: Chronic hepatitis, cirrhosis, hepatocellular carcinoma.

Velocardiofacial Syndrome (DiGeorge Syndrome, 22q11.2 Deletion Syndrome)

  • Definition: Genetic syndrome caused by microdeletion of chromosome 22q11.2.

  • Clinical Features: Congenital heart defects (tetralogy of Fallot, interrupted aortic arch), palatal abnormalities (cleft palate), facial dysmorphism, learning disabilities, immunodeficiency, hypocalcemia.

  • Investigations: Fluorescence in situ hybridization (FISH) or microarray for 22q11.2 deletion, echocardiography, calcium and immune function testing.

  • Management: Multidisciplinary: surgical repair of cardiac defects, speech therapy, calcium supplementation, immunological support.

  • Complications: Recurrent infections, psychiatric disorders, hypocalcemic seizures, developmental delays.

 

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